Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.71 / $80.63	Facility	26	$13.18	$13.71	$80.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.77 / $103.50 / $202.11	Facility	TC	$27.77	$103.50	$202.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.64 / $41.88 / $216.39	Professional		$34.64	$41.88	$216.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $13.60 / $49.97	Professional	26	$11.68	$13.60	$49.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.34 / $26.73 / $66.03	Professional	TC	$22.34	$26.73	$66.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $59.23 / $59.23	Professional		$39.88	$59.23	$59.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $10.40 / $10.40	Professional	26	$9.74	$10.40	$10.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $75.20 / $131.88	Professional		$38.61	$75.20	$131.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.56 / $26.09 / $45.01	Professional	26	$13.56	$26.09	$45.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.33 / $49.57 / $87.41	Professional	TC	$27.33	$49.57	$87.41
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.99 / $47.21 / $110.25	Professional		$35.99	$47.21	$110.25
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $16.23 / $39.83	Professional	26	$11.81	$16.23	$39.83
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.64 / $31.16 / $74.97	Professional	TC	$23.64	$31.16	$74.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $51.94 / $112.88	Professional		$35.26	$51.94	$112.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $17.75 / $37.74	Professional	26	$11.84	$17.75	$37.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $35.02 / $80.28	Professional	TC	$23.17	$35.02	$80.28
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $35.26 / $54.31 / $73.31	Professional		$35.26	$54.31	$73.31
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.34 / $14.70 / $19.85	Professional	26	$12.34	$14.70	$19.85
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.92 / $39.61 / $53.49	Professional	TC	$22.92	$39.61	$53.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $54.06 / $89.79	Professional		$39.96	$54.06	$89.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $17.64 / $27.92	Professional	26	$12.93	$17.64	$27.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.70 / $45.89 / $74.38	Professional	TC	$31.70	$45.89	$74.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.85 / $70.00 / $70.00	Facility	26	$30.85	$70.00	$70.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $56.78 / $158.84 / $158.84	Facility	TC	$56.78	$158.84	$158.84
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $271.47 / $271.47 / $352.20	Professional		$271.47	$271.47	$352.20
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.06 / $81.06 / $104.93	Professional	26	$81.06	$81.06	$104.93
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.40 / $190.40 / $247.28	Professional	TC	$190.40	$190.40	$247.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.39	Professional		$32.34	$32.34	$32.39
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.57 / $58.71 / $113.21	Professional		$36.57	$58.71	$113.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $17.39 / $37.74	Professional	26	$11.84	$17.39	$37.74
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $35.02 / $78.03	Professional	TC	$23.65	$35.02	$78.03
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $136.97 / $136.97 / $136.97	Professional		$136.97	$136.97	$136.97
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $44.97 / $44.97	Professional	26	$44.97	$44.97	$44.97
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $92.01 / $92.01	Professional	TC	$92.01	$92.01	$92.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $49.41 / $60.39	Professional		$43.92	$49.41	$60.39
United Facility/Professional Professional Modifier Low / Median / High Price $31.27 / $45.99 / $118.28	Professional		$31.27	$45.99	$118.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $15.48 / $37.97	Professional	26	$11.37	$15.48	$37.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $30.03 / $85.53	Professional	TC	$19.89	$30.03	$85.53