Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.08 / $9.56 / $60.06	Facility	26	$9.08	$9.56	$60.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.08 / $33.08 / $149.00	Professional		$26.08	$33.08	$149.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.88 / $33.29	Professional	26	$8.13	$9.88	$33.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $22.42 / $62.95	Professional	TC	$17.94	$22.42	$62.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $21.71 / $21.71	Professional	26	$8.23	$21.71	$21.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.75 / $38.88 / $77.73	Professional		$29.75	$38.88	$77.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $12.44 / $24.62	Professional	26	$9.86	$12.44	$24.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $27.05 / $53.12	Professional	TC	$19.67	$27.05	$53.12
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $36.72 / $90.79	Professional		$28.28	$36.72	$90.79
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $12.48 / $27.78	Professional	26	$9.61	$12.48	$27.78
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $24.11 / $60.04	Professional	TC	$19.12	$24.11	$60.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $10.79 / $10.79	Facility	26	$10.79	$10.79	$10.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.80 / $40.22 / $86.00	Professional		$26.80	$40.22	$86.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.65 / $12.17 / $26.83	Professional	26	$8.65	$12.17	$26.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.09 / $28.41 / $62.35	Professional	TC	$18.09	$28.41	$62.35
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $41.40 / $55.89	Professional		$25.98	$41.40	$55.89
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.96 / $14.80	Professional	26	$8.83	$10.96	$14.80
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $30.44 / $41.09	Professional	TC	$17.14	$30.44	$41.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.45 / $40.92 / $66.98	Professional		$30.45	$40.92	$66.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $13.15 / $20.60	Professional	26	$9.59	$13.15	$20.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $35.28 / $57.18	Professional	TC	$24.35	$35.28	$57.18
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $206.60 / $206.60 / $269.25	Professional		$206.60	$206.60	$269.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $78.44 / $78.59	Professional	26	$78.44	$78.44	$78.59
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.73 / $193.00 / $193.00	Professional	TC	$190.73	$193.00	$193.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.05 / $32.34 / $32.34	Professional		$25.05	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.79 / $10.79 / $10.79	Facility	26	$10.79	$10.79	$10.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $44.74 / $86.26	Professional		$28.05	$44.74	$86.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.95 / $26.78	Professional	26	$8.69	$11.95	$26.78
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.14 / $28.12 / $59.54	Professional	TC	$18.14	$28.12	$59.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $103.72 / $103.72 / $103.72	Professional		$103.72	$103.72	$103.72
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $33.35 / $33.35	Professional	26	$33.35	$33.35	$33.35
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $70.37 / $70.37 / $70.37	Professional	TC	$70.37	$70.37	$70.37
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $46.04 / $63.34	Professional		$33.47	$46.04	$63.34
United Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $34.22 / $79.54	Professional		$23.87	$34.22	$79.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $10.74 / $25.88	Professional	26	$7.19	$10.74	$25.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $23.04 / $54.36	Professional	TC	$17.05	$23.04	$54.36