Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.98 / $10.47 / $65.94	Facility	26	$9.98	$10.47	$65.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.26 / $40.40 / $180.00	Professional		$32.26	$40.40	$180.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.97 / $10.09 / $28.64	Professional	26	$8.97	$10.09	$28.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.29 / $29.58 / $76.97	Professional	TC	$23.29	$29.58	$76.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $8.30 / $19.55	Professional	26	$8.30	$8.30	$19.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.68 / $48.65 / $96.22	Professional		$36.68	$48.65	$96.22
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $14.60 / $28.39	Professional	26	$11.46	$14.60	$28.39
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.74 / $34.29 / $68.15	Professional	TC	$24.74	$34.29	$68.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $44.50 / $100.28	Professional		$34.78	$44.50	$100.28
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $13.21 / $30.44	Professional	26	$10.34	$13.21	$30.44
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $24.96 / $31.43 / $76.80	Professional	TC	$24.96	$31.43	$76.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.76 / $50.16 / $106.28	Professional		$33.76	$50.16	$106.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $13.42 / $30.09	Professional	26	$9.63	$13.42	$30.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $36.58 / $83.45	Professional	TC	$24.57	$36.58	$83.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.98 / $53.47 / $72.18	Professional		$25.98	$53.47	$72.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $11.56 / $15.61	Professional	26	$7.79	$11.56	$15.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $41.91 / $56.58	Professional	TC	$18.19	$41.91	$56.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.19 / $53.02 / $89.48	Professional		$39.19	$53.02	$89.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.87 / $21.96	Professional	26	$10.23	$13.87	$21.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.53 / $48.53 / $78.68	Professional	TC	$33.53	$48.53	$78.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $100.00 / $100.00	Facility	26	$29.45	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $267.27 / $267.27 / $344.93	Professional		$267.27	$267.27	$344.93
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.85 / $85.85 / $85.85	Professional	26	$85.85	$85.85	$85.85
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $244.00 / $244.00 / $261.45	Professional	TC	$244.00	$244.00	$261.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $34.22	Professional		$32.34	$32.34	$34.22
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.57 / $55.20 / $111.41	Professional		$34.57	$55.20	$111.41
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $13.11 / $28.32	Professional	26	$9.63	$13.11	$28.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $36.01 / $78.13	Professional	TC	$24.57	$36.01	$78.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $132.41 / $132.41 / $132.41	Professional		$132.41	$132.41	$132.41
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $36.79 / $36.79 / $36.79	Professional	26	$36.79	$36.79	$36.79
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $95.61 / $95.61 / $95.61	Professional	TC	$95.61	$95.61	$95.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $52.16 / $63.34	Professional		$38.96	$52.16	$63.34
United Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $41.35 / $100.20	Professional		$28.42	$41.35	$100.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.58 / $11.87 / $31.08	Professional	26	$8.58	$11.87	$31.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.74 / $29.21 / $71.75	Professional	TC	$20.74	$29.21	$71.75