Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.84 / $13.51 / $82.57	Facility	26	$12.84	$13.51	$82.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $49.50 / $233.00	Professional		$38.09	$49.50	$233.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.54 / $13.95 / $47.69	Professional	26	$11.54	$13.95	$47.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $34.14 / $87.76	Professional	TC	$26.55	$34.14	$87.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $48.18 / $51.20	Professional		$48.18	$48.18	$51.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $21.83 / $21.83	Professional	26	$9.86	$21.83	$21.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $56.59 / $111.11	Professional		$43.34	$56.59	$111.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $18.42 / $36.35	Professional	26	$14.60	$18.42	$36.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $38.68 / $77.23	Professional	TC	$27.38	$38.68	$77.23
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $41.00 / $51.86 / $118.20	Professional		$41.00	$51.86	$118.20
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $16.55 / $38.63	Professional	26	$12.93	$16.55	$38.63
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.43 / $35.70 / $92.42	Professional	TC	$28.43	$35.70	$92.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $58.69 / $125.63	Professional		$38.35	$58.69	$125.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.91 / $17.03 / $37.65	Professional	26	$11.91	$17.03	$37.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $41.06 / $93.52	Professional	TC	$27.69	$41.06	$93.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.89 / $62.01 / $83.71	Professional		$37.89	$62.01	$83.71
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $15.05 / $20.32	Professional	26	$12.12	$15.05	$20.32
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.77 / $46.96 / $63.40	Professional	TC	$25.77	$46.96	$63.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $61.19 / $102.24	Professional		$45.50	$61.19	$102.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.25 / $18.05 / $28.29	Professional	26	$13.25	$18.05	$28.29
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 $400.05 / $438.00 / $438.00	Professional		$400.05	$438.00	$438.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.41 / $97.41 / $107.48	Professional	26	$97.41	$97.41	$107.48
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $292.58 / $423.00 / $423.00	Professional	TC	$292.58	$423.00	$423.00
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 $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Providence Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $63.74 / $130.28	Professional		$40.28	$63.74	$130.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $16.77 / $36.83	Professional	26	$12.00	$16.77	$36.83
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.97 / $40.64 / $88.64	Professional	TC	$27.97	$40.64	$88.64
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $154.96 / $154.96 / $154.96	Professional		$154.96	$154.96	$154.96
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $46.12 / $46.12 / $46.12	Professional	26	$46.12	$46.12	$46.12
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 $50.15 / $68.95 / $94.08	Professional		$50.15	$68.95	$94.08
United Facility/Professional Professional Modifier Low / Median / High Price $33.53 / $49.95 / $142.66	Professional		$33.53	$49.95	$142.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.79 / $15.25 / $34.29	Professional	26	$10.79	$15.25	$34.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.58 / $32.84 / $84.10	Professional	TC	$23.58	$32.84	$84.10