Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $10.17 / $42.10	Professional	26	$8.49	$10.17	$42.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $26.66 / $113.19	Professional	TC	$21.48	$26.66	$113.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.02 / $13.91 / $26.81	Professional	26	$11.02	$13.91	$26.81
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.62 / $31.37 / $63.29	Professional	TC	$22.62	$31.37	$63.29
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.28 / $13.28 / $29.57	Professional	26	$10.28	$13.28	$29.57
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $24.59 / $30.98 / $72.88	Professional	TC	$24.59	$30.98	$72.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $13.30 / $29.61	Professional	26	$9.44	$13.30	$29.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.44 / $33.86 / $77.12	Professional	TC	$22.44	$33.86	$77.12
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $12.12 / $16.36	Professional	26	$7.79	$12.12	$16.36
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $36.40 / $49.14	Professional	TC	$18.19	$36.40	$49.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $14.54 / $22.79	Professional	26	$10.60	$14.54	$22.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.12 / $42.17 / $68.36	Professional	TC	$29.12	$42.17	$68.36
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.59 / $77.59 / $86.55	Professional	26	$77.59	$77.59	$86.55
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $227.48 / $300.00 / $300.00	Professional	TC	$227.48	$300.00	$300.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $13.11 / $29.25	Professional	26	$9.47	$13.11	$29.25
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.55 / $33.47 / $72.66	Professional	TC	$22.55	$33.47	$72.66
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $36.85 / $36.85 / $36.85	Professional	26	$36.85	$36.85	$36.85
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $90.80 / $90.80	Professional	TC	$90.80	$90.80	$90.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.55 / $27.64	Professional	26	$8.02	$11.55	$27.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $28.23 / $70.62	Professional	TC	$19.32	$28.23	$70.62