Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.02 / $9.46 / $59.56	Facility	26	$9.02	$9.46	$59.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.91 / $38.20 / $161.00	Professional		$28.91	$38.20	$161.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $9.69 / $34.79	Professional	26	$8.26	$9.69	$34.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.68 / $24.98 / $71.86	Professional	TC	$19.68	$24.98	$71.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.58 / $33.58 / $47.01	Professional		$33.58	$33.58	$47.01
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $10.64 / $21.05	Professional	26	$7.09	$10.64	$21.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $42.18 / $84.87	Professional		$31.46	$42.18	$84.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $13.01 / $25.93	Professional	26	$10.48	$13.01	$25.93
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $29.18 / $58.05	Professional	TC	$21.06	$29.18	$58.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.12 / $37.21 / $95.90	Professional		$29.12	$37.21	$95.90
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $11.94 / $27.51	Professional	26	$9.36	$11.94	$27.51
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $24.57 / $63.74	Professional	TC	$19.48	$24.57	$63.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $42.82 / $86.70	Professional		$27.60	$42.82	$86.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.55 / $12.16 / $27.16	Professional	26	$8.55	$12.16	$27.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $30.55 / $66.61	Professional	TC	$19.32	$30.55	$66.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $43.13 / $58.23	Professional		$25.98	$43.13	$58.23
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $10.40 / $14.04	Professional	26	$8.57	$10.40	$14.04
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.41 / $32.72 / $44.19	Professional	TC	$17.41	$32.72	$44.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $42.91 / $72.44	Professional		$31.71	$42.91	$72.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $12.48 / $19.73	Professional	26	$9.22	$12.48	$19.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.18 / $37.92 / $61.48	Professional	TC	$26.18	$37.92	$61.48
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $217.42 / $217.42 / $280.35	Professional		$217.42	$217.42	$280.35
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.64 / $72.64 / $75.53	Professional	26	$72.64	$72.64	$75.53
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.00 / $199.00 / $204.83	Professional	TC	$199.00	$199.00	$204.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $32.34 / $32.34	Professional		$26.89	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $46.99 / $90.75	Professional		$28.92	$46.99	$90.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $11.93 / $27.10	Professional	26	$8.59	$11.93	$27.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $30.18 / $64.54	Professional	TC	$19.48	$30.18	$64.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $108.48 / $108.48 / $108.48	Professional		$108.48	$108.48	$108.48
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $33.29 / $33.29	Professional	26	$33.29	$33.29	$33.29
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $75.18 / $75.18 / $75.18	Professional	TC	$75.18	$75.18	$75.18
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $47.95 / $63.34	Professional		$34.86	$47.95	$63.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $35.69 / $83.17	Professional		$25.86	$35.69	$83.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $10.65 / $28.12	Professional	26	$7.74	$10.65	$28.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.47 / $25.00 / $58.08	Professional	TC	$18.47	$25.00	$58.08