Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $10.00 / $22.91	Facility	26	$7.41	$10.00	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $53.70 / $169.82	Professional		$30.20	$53.70	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.88 / $43.65	Professional	26	$7.08	$12.88	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $35.48 / $123.03	Professional	TC	$22.39	$35.48	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $81.28	Professional		$28.84	$53.70	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $14.13 / $19.95	Professional	26	$6.76	$14.13	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $31.62 / $63.10	Professional	TC	$27.54	$31.62	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $43.65 / $87.10	Professional		$33.11	$43.65	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $23.99	Professional	26	$9.12	$12.30	$23.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $30.90 / $66.07	Professional	TC	$23.44	$30.90	$66.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $48.98 / $95.50	Professional		$36.31	$48.98	$95.50
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $21.88	Professional	26	$9.12	$12.02	$21.88
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $74.13	Professional	TC	$26.92	$36.31	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $83.18	Professional		$29.51	$42.66	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.72 / $21.38	Professional	26	$7.41	$10.72	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $32.36 / $69.18	Professional	TC	$21.38	$32.36	$69.18
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $50.12 / $67.61	Professional		$24.55	$50.12	$67.61
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.55 / $13.18	Professional	26	$6.46	$9.55	$13.18
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $40.74 / $54.95	Professional	TC	$18.20	$40.74	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $46.77 / $81.28	Professional		$36.31	$46.77	$81.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $18.20	Professional	26	$8.51	$11.22	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $43.65 / $75.86	Professional	TC	$33.88	$43.65	$75.86
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 $245.47 / $316.23 / $316.23	Professional		$245.47	$316.23	$316.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $67.61 / $67.61	Professional	26	$61.66	$67.61	$67.61
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $251.19 / $251.19	Professional	TC	$190.55	$251.19	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $33.11 / $42.66	Professional		$10.00	$33.11	$42.66
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $95.50	Professional		$29.51	$44.67	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.23 / $19.95	Professional	26	$7.41	$10.23	$19.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $64.57	Professional	TC	$20.42	$30.20	$64.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	26	$28.84	$28.84	$28.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $45.71 / $60.26	Professional		$37.15	$45.71	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $77.62	Professional		$23.99	$37.15	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $18.20	Professional	26	$6.46	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $27.54 / $60.26	Professional	TC	$16.98	$27.54	$60.26