Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $14.45 / $74.13	Facility	26	$10.96	$14.45	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $199.53	Professional		$34.67	$56.23	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $46.77	Professional	26	$10.00	$16.22	$46.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $107.15	Professional	TC	$23.99	$34.67	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $81.28	Professional		$35.48	$43.65	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $19.50 / $26.92	Professional	26	$9.77	$19.50	$26.92
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	TC	$57.54	$57.54	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $109.65	Professional		$39.81	$53.70	$109.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $33.88	Professional	26	$13.18	$18.20	$33.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $35.48 / $74.13	Professional	TC	$26.92	$35.48	$74.13
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $112.20	Professional		$42.66	$57.54	$112.20
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.38 / $31.62	Professional	26	$13.18	$17.38	$31.62
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $81.28	Professional	TC	$28.18	$39.81	$81.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $13.80 / $19.50	Facility	26	$2.95	$13.80	$19.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $52.48 / $100.00	Professional		$34.67	$52.48	$100.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.49 / $30.90	Professional	26	$10.72	$15.49	$30.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $74.13	Professional	TC	$23.99	$36.31	$74.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $77.62	Professional		$33.88	$57.54	$77.62
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $13.49 / $18.20	Professional	26	$10.96	$13.49	$18.20
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $43.65 / $58.88	Professional	TC	$22.91	$43.65	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $95.50	Professional		$41.69	$53.70	$95.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $25.70	Professional	26	$12.02	$15.85	$25.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $46.77 / $83.18	Professional	TC	$36.31	$46.77	$83.18
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $363.08	Professional		$281.84	$363.08	$363.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $97.72 / $97.72	Professional	26	$91.20	$97.72	$97.72
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $269.15 / $269.15	Professional	TC	$208.93	$269.15	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $33.11 / $48.98	Professional		$13.80	$33.11	$48.98
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $13.80 / $19.50	Facility	26	$2.95	$13.80	$19.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $54.95 / $109.65	Professional		$35.48	$54.95	$109.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.45 / $28.84	Professional	26	$10.72	$14.45	$28.84
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $34.67 / $69.18	Professional	TC	$23.99	$34.67	$69.18
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	26	$41.69	$41.69	$41.69
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	TC	$100.00	$100.00	$100.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $93.33	Professional		$46.77	$64.57	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $42.66 / $91.20	Professional		$28.84	$42.66	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.88 / $26.30	Professional	26	$9.12	$12.88	$26.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $30.20 / $64.57	Professional	TC	$19.95	$30.20	$64.57