Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $8.55 / $51.19	Facility	26	$8.13	$8.55	$51.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.45 / $34.36 / $155.00	Professional		$27.45	$34.36	$155.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.30 / $8.60 / $22.60	Professional	26	$7.30	$8.60	$22.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.92 / $24.98 / $66.18	Professional	TC	$19.92	$24.98	$66.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.67 / $45.74 / $57.35	Professional		$26.67	$45.74	$57.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $13.82 / $18.69	Professional	26	$6.41	$13.82	$18.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.42 / $39.65 / $78.95	Professional		$30.42	$39.65	$78.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.00 / $11.39 / $22.61	Professional	26	$9.00	$11.39	$22.61
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.54 / $28.68 / $56.05	Professional	TC	$21.54	$28.68	$56.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $36.76 / $92.99	Professional		$28.45	$36.76	$92.99
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $24.33	Professional	26	$8.07	$10.27	$24.33
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.94 / $26.40 / $64.08	Professional	TC	$20.94	$26.40	$64.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $40.56 / $86.78	Professional		$26.86	$40.56	$86.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $10.63 / $23.34	Professional	26	$7.42	$10.63	$23.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $30.02 / $65.54	Professional	TC	$19.36	$30.02	$65.54
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $42.07 / $56.79	Professional		$21.62	$42.07	$56.79
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.05 / $9.34 / $12.61	Professional	26	$6.05	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.57 / $32.72 / $44.19	Professional	TC	$15.57	$32.72	$44.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $41.48 / $69.33	Professional		$30.86	$41.48	$69.33
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 $26.18 / $37.92 / $61.48	Professional	TC	$26.18	$37.92	$61.48
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 $208.83 / $208.83 / $272.63	Professional		$208.83	$208.83	$272.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $66.04 / $66.04 / $67.73	Professional	26	$66.04	$66.04	$67.73
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $188.00 / $188.00 / $204.83	Professional	TC	$188.00	$188.00	$204.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $32.34 / $32.34	Professional		$26.52	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.61 / $9.61 / $9.61	Facility	26	$9.61	$9.61	$9.61
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.83 / $44.83 / $87.15	Professional		$27.83	$44.83	$87.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.46 / $10.45 / $22.86	Professional	26	$7.46	$10.45	$22.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $29.78 / $65.00	Professional	TC	$19.93	$29.78	$65.00
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $102.62 / $102.62 / $102.62	Professional		$102.62	$102.62	$102.62
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 $73.97 / $73.97 / $73.97	Professional	TC	$73.97	$73.97	$73.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $43.42 / $52.72	Professional		$32.43	$43.42	$52.72
United Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $34.04 / $81.59	Professional		$23.30	$34.04	$81.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.15 / $22.25	Professional	26	$6.64	$9.15	$22.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $24.80 / $73.22	Professional	TC	$17.32	$24.80	$73.22