Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.29 / $11.89 / $72.31	Facility	26	$11.29	$11.89	$72.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $59.89 / $244.97	Professional		$43.78	$59.89	$244.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $11.89 / $50.57	Professional	26	$10.11	$11.89	$50.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $41.31 / $125.09	Professional	TC	$33.15	$41.31	$125.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.43 / $111.43 / $111.43	Professional		$111.43	$111.43	$111.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.97 / $12.97 / $14.15	Professional	26	$12.97	$12.97	$14.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.06 / $59.75 / $119.87	Professional		$46.06	$59.75	$119.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $16.00 / $30.90	Professional	26	$12.58	$16.00	$30.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.13 / $44.62 / $91.42	Professional	TC	$32.13	$44.62	$91.42
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $58.65 / $129.99	Professional		$45.77	$58.65	$129.99
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $14.95 / $34.46	Professional	26	$11.66	$14.95	$34.46
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $35.02 / $43.77 / $100.00	Professional	TC	$35.02	$43.77	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $13.10	Facility	26	$13.10	$13.10	$13.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.84 / $63.26 / $138.90	Professional		$42.84	$63.26	$138.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $14.87 / $33.10	Professional	26	$10.68	$14.87	$33.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $48.63 / $114.36	Professional	TC	$32.29	$48.63	$114.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.09 / $69.78 / $94.20	Professional		$38.09	$69.78	$94.20
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.52 / $12.72 / $17.17	Professional	26	$9.52	$12.72	$17.17
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.57 / $57.06 / $77.03	Professional	TC	$28.57	$57.06	$77.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $68.53 / $114.41	Professional		$50.92	$68.53	$114.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $15.26 / $23.91	Professional	26	$11.23	$15.26	$23.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.65 / $66.03 / $107.07	Professional	TC	$45.65	$66.03	$107.07
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 $345.31 / $345.31 / $446.25	Professional		$345.31	$345.31	$446.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $142.00 / $142.00 / $142.00	Professional	26	$142.00	$142.00	$142.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.83 / $272.83 / $354.75	Professional	TC	$272.83	$272.83	$354.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $45.96	Professional		$32.34	$32.34	$45.96
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $13.10	Facility	26	$13.10	$13.10	$13.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.30 / $69.11 / $143.76	Professional		$44.30	$69.11	$143.76
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $14.57 / $31.32	Professional	26	$10.83	$14.57	$31.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $47.43 / $107.32	Professional	TC	$32.94	$47.43	$107.32
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $171.99 / $171.99 / $171.99	Professional		$171.99	$171.99	$171.99
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.31 / $40.31 / $40.31	Professional	26	$40.31	$40.31	$40.31
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $131.68 / $131.68 / $131.68	Professional	TC	$131.68	$131.68	$131.68
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.44 / $76.48 / $92.87	Professional		$56.44	$76.48	$92.87
United Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $54.17 / $131.75	Professional		$34.96	$54.17	$131.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $13.03 / $31.23	Professional	26	$9.41	$13.03	$31.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $39.70 / $98.80	Professional	TC	$26.43	$39.70	$98.80