Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.39 / $15.13 / $95.32	Facility	26	$14.39	$15.13	$95.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.74 / $58.57 / $261.05	Professional		$45.74	$58.57	$261.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.82 / $64.69	Professional	26	$13.58	$15.82	$64.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.49 / $40.61 / $88.66	Professional	TC	$32.49	$40.61	$88.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.20 / $56.12 / $74.50	Professional		$43.20	$56.12	$74.50
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $12.56 / $31.10	Professional	26	$11.34	$12.56	$31.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $65.87 / $127.00	Professional		$49.04	$65.87	$127.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $21.06 / $40.82	Professional	26	$16.35	$21.06	$40.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.29 / $45.11 / $87.65	Professional	TC	$32.29	$45.11	$87.65
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $45.61 / $60.00 / $136.80	Professional		$45.61	$60.00	$136.80
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $19.27 / $43.90	Professional	26	$15.16	$19.27	$43.90
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $31.73 / $40.54 / $100.00	Professional	TC	$31.73	$40.54	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $66.48 / $140.55	Professional		$43.34	$66.48	$140.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $19.43 / $43.47	Professional	26	$13.64	$19.43	$43.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.15 / $47.27 / $103.90	Professional	TC	$30.15	$47.27	$103.90
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $67.69 / $91.38	Professional		$42.40	$67.69	$91.38
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.99 / $17.05 / $23.03	Professional	26	$13.99	$17.05	$23.03
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.41 / $50.63 / $68.34	Professional	TC	$28.41	$50.63	$68.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.78 / $67.36 / $113.74	Professional		$49.78	$67.36	$113.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.10 / $20.47 / $32.39	Professional	26	$15.10	$20.47	$32.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.50 / $58.61 / $95.01	Professional	TC	$40.50	$58.61	$95.01
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.63 / $100.00 / $100.00	Facility	26	$46.63	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $338.57 / $338.57 / $439.80	Professional		$338.57	$338.57	$439.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.24 / $117.24 / $124.65	Professional	26	$117.24	$117.24	$124.65
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $291.00 / $291.00 / $315.14	Professional	TC	$291.00	$291.00	$315.14
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $41.19	Professional		$32.34	$32.34	$41.19
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
Providence Facility/Professional Professional Modifier Low / Median / High Price $45.52 / $72.93 / $141.06	Professional		$45.52	$72.93	$141.06
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.68 / $19.19 / $41.42	Professional	26	$13.68	$19.19	$41.42
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $30.32 / $46.32 / $99.31	Professional	TC	$30.32	$46.32	$99.31
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $170.39 / $170.39 / $170.39	Professional		$170.39	$170.39	$170.39
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $53.13 / $53.13 / $53.13	Professional	26	$53.13	$53.13	$53.13
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $117.25 / $117.25 / $117.25	Professional	TC	$117.25	$117.25	$117.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $75.26 / $132.27	Professional		$54.74	$75.26	$132.27
United Facility/Professional Professional Modifier Low / Median / High Price $39.22 / $57.04 / $130.51	Professional		$39.22	$57.04	$130.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $16.98 / $44.88	Professional	26	$12.17	$16.98	$44.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.14 / $38.46 / $90.60	Professional	TC	$28.14	$38.46	$90.60