Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.73 / $10.27 / $62.00	Facility	26	$9.73	$10.27	$62.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.30 / $21.21 / $74.81	Professional		$16.30	$21.21	$74.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.02 / $38.64	Professional	26	$8.71	$10.02	$38.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $7.29 / $10.43 / $16.60	Professional	TC	$7.29	$10.43	$16.60
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $17.39 / $22.51	Professional	26	$7.40	$17.39	$22.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.49 / $30.71 / $57.61	Professional		$21.49	$30.71	$57.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.86 / $13.40 / $25.83	Professional	26	$10.86	$13.40	$25.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $9.97 / $15.72 / $36.38	Professional	TC	$9.97	$15.72	$36.38
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.34 / $24.98 / $58.15	Professional		$19.34	$24.98	$58.15
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.30 / $13.06 / $29.77	Professional	26	$10.30	$13.06	$29.77
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $9.25 / $11.99 / $31.66	Professional	TC	$9.25	$11.99	$31.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.97 / $29.10 / $56.01	Professional		$16.97	$29.10	$56.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $12.77 / $28.39	Professional	26	$8.94	$12.77	$28.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.02 / $15.62 / $31.33	Professional	TC	$8.02	$15.62	$31.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $16.04 / $23.39 / $31.58	Professional		$16.04	$23.39	$31.58
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $11.31 / $15.27	Professional	26	$8.34	$11.31	$15.27
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.70 / $12.08 / $16.30	Professional	TC	$7.70	$12.08	$16.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.13 / $23.41 / $43.00	Professional		$18.13	$23.41	$43.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $13.57 / $21.49	Professional	26	$9.92	$13.57	$21.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $9.66 / $14.06 / $22.77	Professional	TC	$9.66	$14.06	$22.77
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $100.00 / $100.00	Facility	26	$29.45	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $186.44 / $206.87 / $206.87	Professional		$186.44	$206.87	$206.87
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $105.66 / $105.66 / $105.66	Professional	26	$105.66	$105.66	$105.66
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.58 / $133.46 / $133.46	Professional	TC	$129.58	$133.46	$133.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.54 / $32.34 / $32.34	Professional		$11.54	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.16 / $11.16 / $11.16	Facility	26	$11.16	$11.16	$11.16
Providence Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $32.85 / $52.92	Professional		$17.39	$32.85	$52.92
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $12.58 / $27.10	Professional	26	$9.27	$12.58	$27.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $8.02 / $15.94 / $31.33	Professional	TC	$8.02	$15.94	$31.33
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $62.80 / $62.80	Professional		$62.80	$62.80	$62.80
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $34.50 / $34.50	Professional	26	$34.50	$34.50	$34.50
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $28.29 / $28.29 / $28.29	Professional	TC	$28.29	$28.29	$28.29
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $25.99 / $93.15	Professional		$18.89	$25.99	$93.15
United Facility/Professional Professional Modifier Low / Median / High Price $17.75 / $22.51 / $50.89	Professional		$17.75	$22.51	$50.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.50 / $28.28	Professional	26	$8.02	$11.50	$28.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $8.28 / $11.26 / $29.09	Professional	TC	$8.28	$11.26	$29.09