Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $15.49 / $34.67	Facility	26	$12.02	$15.49	$34.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $56.23 / $186.21	Professional		$27.54	$56.23	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $17.78 / $51.29	Professional	26	$11.48	$17.78	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $117.49	Professional	TC	$23.99	$41.69	$117.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $45.71 / $85.11	Professional		$33.88	$45.71	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $18.62 / $30.20	Professional	26	$10.47	$18.62	$30.20
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $47.86	Professional	TC	$20.89	$31.62	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $109.65	Professional		$40.74	$54.95	$109.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.05 / $36.31	Professional	26	$14.13	$19.05	$36.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $74.13	Professional	TC	$26.92	$36.31	$74.13
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $109.65	Professional		$40.74	$56.23	$109.65
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.05 / $34.67	Professional	26	$14.13	$19.05	$34.67
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $79.43	Professional	TC	$25.70	$37.15	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $95.50	Professional		$34.67	$51.29	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $16.60 / $33.11	Professional	26	$11.22	$16.60	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $69.18	Professional	TC	$23.44	$34.67	$69.18
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $74.13	Professional		$32.36	$54.95	$74.13
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $14.45 / $19.50	Professional	26	$11.75	$14.45	$19.50
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $40.74 / $54.95	Professional	TC	$20.89	$40.74	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $52.48 / $91.20	Professional		$40.74	$52.48	$91.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.60 / $26.30	Professional	26	$12.59	$16.60	$26.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $43.65 / $75.86	Professional	TC	$33.88	$43.65	$75.86
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $354.81	Professional		$269.15	$354.81	$354.81
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $102.33 / $102.33	Professional	26	$93.33	$102.33	$102.33
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $251.19 / $251.19	Professional	TC	$229.09	$251.19	$251.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $33.11 / $47.86	Professional		$15.14	$33.11	$47.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $107.15	Professional		$34.67	$53.70	$107.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $15.85 / $30.20	Professional	26	$11.22	$15.85	$30.20
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $64.57	Professional	TC	$22.91	$33.88	$64.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Professional		$134.90	$134.90	$134.90
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	26	$43.65	$43.65	$43.65
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $104.71	Professional		$44.67	$61.66	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $41.69 / $87.10	Professional		$29.51	$41.69	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $13.80 / $27.54	Professional	26	$10.00	$13.80	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $61.66	Professional	TC	$19.95	$27.54	$61.66