Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $14.45 / $87.10	Facility	26	$12.02	$14.45	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $218.78	Professional		$36.31	$58.88	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.20 / $47.86	Professional	26	$10.96	$18.20	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $128.82	Professional	TC	$23.99	$37.15	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $38.90 / $61.66	Professional		$33.11	$38.90	$61.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.70 / $30.90	Professional	26	$23.99	$25.70	$30.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $19.95	Professional	TC	$19.95	$19.95	$19.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $60.26 / $114.82	Professional		$41.69	$60.26	$114.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.50 / $37.15	Professional	26	$14.13	$19.50	$37.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $77.62	Professional	TC	$28.18	$40.74	$77.62
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $58.88 / $114.82	Professional		$41.69	$58.88	$114.82
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.05 / $35.48	Professional	26	$14.45	$19.05	$35.48
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $83.18	Professional	TC	$26.92	$38.90	$83.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $102.33	Professional		$36.31	$54.95	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.98 / $34.67	Professional	26	$11.75	$16.98	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $70.79	Professional	TC	$23.99	$37.15	$70.79
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $56.23 / $75.86	Professional		$33.11	$56.23	$75.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.49 / $20.89	Professional	26	$11.75	$15.49	$20.89
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $40.74 / $54.95	Professional	TC	$21.88	$40.74	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $91.20	Professional		$41.69	$53.70	$91.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.78 / $29.51	Professional	26	$13.49	$17.78	$29.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $44.67 / $77.62	Professional	TC	$33.88	$44.67	$77.62
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 $281.84 / $363.08 / $363.08	Professional		$281.84	$363.08	$363.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $109.65 / $109.65	Professional	26	$100.00	$109.65	$109.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $257.04 / $257.04	Professional	TC	$251.19	$257.04	$257.04
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $33.11 / $50.12	Professional		$16.22	$33.11	$50.12
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $57.54 / $109.65	Professional		$36.31	$57.54	$109.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.22 / $32.36	Professional	26	$11.75	$16.22	$32.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $66.07	Professional	TC	$23.99	$36.31	$66.07
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Professional	26	$48.98	$48.98	$48.98
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $95.50 / $95.50	Professional	TC	$95.50	$95.50	$95.50
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $93.33	Professional		$46.77	$63.10	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $91.20	Professional		$31.62	$43.65	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $15.14 / $30.20	Professional	26	$10.23	$15.14	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.18 / $63.10	Professional	TC	$22.39	$28.18	$63.10