Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.23 / $11.79 / $74.25	Facility	26	$11.23	$11.79	$74.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $47.15 / $198.76	Professional		$35.67	$47.15	$198.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $12.55 / $48.12	Professional	26	$10.23	$12.55	$48.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $31.24 / $80.92	Professional	TC	$24.79	$31.24	$80.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $57.39 / $97.01	Professional		$44.14	$57.39	$97.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $9.92 / $27.17	Professional	26	$8.93	$9.92	$27.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $50.00 / $98.04	Professional		$38.25	$50.00	$98.04
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $16.57 / $32.61	Professional	26	$12.97	$16.57	$32.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.00 / $33.89 / $66.06	Professional	TC	$24.00	$33.89	$66.06
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $36.59 / $46.55 / $105.48	Professional		$36.59	$46.55	$105.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $14.88 / $34.29	Professional	26	$11.63	$14.88	$34.29
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.51 / $32.02 / $83.15	Professional	TC	$25.51	$32.02	$83.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.24 / $51.33 / $111.89	Professional		$34.24	$51.33	$111.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.65 / $15.13 / $33.86	Professional	26	$10.65	$15.13	$33.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.03 / $36.21 / $85.80	Professional	TC	$24.03	$36.21	$85.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $56.82 / $76.70	Professional		$34.04	$56.82	$76.70
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.89 / $13.53 / $18.27	Professional	26	$10.89	$13.53	$18.27
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.15 / $43.29 / $58.44	Professional	TC	$23.15	$43.29	$58.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.68 / $56.06 / $93.67	Professional		$41.68	$56.06	$93.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $16.23 / $25.44	Professional	26	$11.92	$16.23	$25.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.63 / $50.12 / $81.26	Professional	TC	$34.63	$50.12	$81.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $282.36 / $282.36 / $366.83	Professional		$282.36	$282.36	$366.83
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $90.81 / $90.81 / $96.90	Professional	26	$90.81	$90.81	$96.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $211.00 / $211.00 / $269.93	Professional	TC	$211.00	$211.00	$269.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $34.95	Professional		$32.34	$32.34	$34.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $56.09 / $117.70	Professional		$36.26	$56.09	$117.70
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $14.86 / $33.00	Professional	26	$10.68	$14.86	$33.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.41 / $35.40 / $78.88	Professional	TC	$24.41	$35.40	$78.88
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $140.69 / $140.69 / $140.69	Professional		$140.69	$140.69	$140.69
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $41.46 / $41.46 / $41.46	Professional	26	$41.46	$41.46	$41.46
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $99.22 / $99.22 / $99.22	Professional	TC	$99.22	$99.22	$99.22
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.95 / $63.18 / $93.15	Professional		$45.95	$63.18	$93.15
United Facility/Professional Professional Modifier Low / Median / High Price $29.04 / $43.80 / $124.31	Professional		$29.04	$43.80	$124.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $13.95 / $37.29	Professional	26	$9.68	$13.95	$37.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.18 / $29.96 / $74.43	Professional	TC	$20.18	$29.96	$74.43