Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.89 / $12.50 / $78.68	Facility	26	$11.89	$12.50	$78.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $48.35 / $208.79	Professional		$38.36	$48.35	$208.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.98 / $12.91 / $52.43	Professional	26	$10.98	$12.91	$52.43
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.55 / $34.33 / $134.71	Professional	TC	$27.55	$34.33	$134.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.52 / $47.22 / $210.97	Professional		$38.52	$47.22	$210.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $12.78 / $23.49	Professional	26	$9.89	$12.78	$23.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $55.08 / $108.43	Professional		$42.62	$55.08	$108.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.51 / $17.05 / $33.90	Professional	26	$13.51	$17.05	$33.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $38.29 / $76.23	Professional	TC	$27.38	$38.29	$76.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $51.13 / $114.73	Professional		$39.79	$51.13	$114.73
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.75 / $36.28	Professional	26	$12.30	$15.75	$36.28
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $35.70 / $91.42	Professional	TC	$28.43	$35.70	$91.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.78 / $57.55 / $123.86	Professional		$37.78	$57.55	$123.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $15.79 / $35.82	Professional	26	$11.23	$15.79	$35.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $40.90 / $94.55	Professional	TC	$27.69	$40.90	$94.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.28 / $60.85 / $82.15	Professional		$37.28	$60.85	$82.15
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $13.88 / $18.73	Professional	26	$11.56	$13.88	$18.73
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.72 / $46.96 / $63.40	Professional	TC	$25.72	$46.96	$63.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.60 / $59.98 / $100.22	Professional		$44.60	$59.98	$100.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $16.66 / $26.09	Professional	26	$12.24	$16.66	$26.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.57 / $54.36 / $88.14	Professional	TC	$37.57	$54.36	$88.14
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 $306.22 / $306.22 / $392.03	Professional		$306.22	$306.22	$392.03
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.76 / $95.76 / $99.45	Professional	26	$95.76	$95.76	$99.45
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $250.00 / $250.00 / $292.58	Professional	TC	$250.00	$250.00	$292.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $38.26	Professional		$32.34	$32.34	$38.26
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $62.21 / $127.59	Professional		$39.40	$62.21	$127.59
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $15.53 / $34.00	Professional	26	$11.25	$15.53	$34.00
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.97 / $40.36 / $87.98	Professional	TC	$27.97	$40.36	$87.98
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $152.66 / $152.66 / $152.66	Professional		$152.66	$152.66	$152.66
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $43.82 / $43.82	Professional	26	$43.82	$43.82	$43.82
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $108.84 / $108.84 / $108.84	Professional	TC	$108.84	$108.84	$108.84
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $49.21 / $67.66 / $93.15	Professional		$49.21	$67.66	$93.15
United Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $49.22 / $116.71	Professional		$32.40	$49.22	$116.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $13.71 / $32.69	Professional	26	$9.96	$13.71	$32.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.30 / $35.72 / $84.64	Professional	TC	$23.30	$35.72	$84.64