Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $8.66 / $51.19	Facility	26	$7.78	$8.66	$51.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $45.07 / $170.00	Professional		$29.89	$45.07	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.18 / $43.00	Professional	26	$7.33	$10.18	$43.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $29.35 / $87.93	Professional	TC	$22.57	$29.35	$87.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.06 / $40.57 / $81.81	Professional		$31.06	$40.57	$81.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.16 / $10.40 / $13.56	Professional	26	$6.16	$10.40	$13.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.31 / $40.61 / $80.83	Professional		$30.31	$40.61	$80.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.39 / $22.42	Professional	26	$8.99	$11.39	$22.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.56 / $29.66 / $57.64	Professional	TC	$22.56	$29.66	$57.64
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $40.36 / $100.00	Professional		$32.18	$40.36	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $23.67	Professional	26	$8.07	$10.27	$23.67
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $30.05 / $71.95	Professional	TC	$23.86	$30.05	$71.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $42.71 / $97.70	Professional		$29.52	$42.71	$97.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $10.58 / $23.42	Professional	26	$7.42	$10.58	$23.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $32.11 / $79.43	Professional	TC	$21.85	$32.11	$79.43
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.79 / $49.42 / $66.72	Professional		$24.79	$49.42	$66.72
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.45 / $9.34 / $12.61	Professional	26	$6.45	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.34 / $40.08 / $54.11	Professional	TC	$18.34	$40.08	$54.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $48.58 / $81.14	Professional		$36.11	$48.58	$81.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.21 / $17.55	Professional	26	$8.23	$11.21	$17.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.06 / $46.41 / $75.23	Professional	TC	$32.06	$46.41	$75.23
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 $245.68 / $245.68 / $317.85	Professional		$245.68	$245.68	$317.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $61.09 / $61.09 / $67.73	Professional	26	$61.09	$61.09	$67.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $192.57 / $192.57 / $250.13	Professional	TC	$192.57	$192.57	$250.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $33.11	Professional		$32.34	$32.34	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $48.97 / $102.43	Professional		$30.00	$48.97	$102.43
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.46 / $10.39 / $23.37	Professional	26	$7.46	$10.39	$23.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.85 / $31.80 / $74.33	Professional	TC	$21.85	$31.80	$74.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $120.65 / $120.65 / $120.65	Professional		$120.65	$120.65	$120.65
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $28.64 / $28.64	Professional	26	$28.64	$28.64	$28.64
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $92.01 / $92.01	Professional	TC	$92.01	$92.01	$92.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.19 / $49.79 / $60.45	Professional		$37.19	$49.79	$60.45
United Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $36.81 / $101.30	Professional		$23.78	$36.81	$101.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.02 / $21.32	Professional	26	$6.64	$9.02	$21.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $27.79 / $69.03	Professional	TC	$17.14	$27.79	$69.03