Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.98 / $10.76 / $67.88	Facility	26	$9.98	$10.76	$67.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.17 / $46.26 / $183.00	Professional		$34.17	$46.26	$183.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $11.16 / $44.28	Professional	26	$9.41	$11.16	$44.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $30.32 / $115.00	Professional	TC	$24.72	$30.32	$115.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.80 / $41.00 / $71.04	Professional		$27.80	$41.00	$71.04
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $11.52 / $20.23	Professional	26	$7.95	$11.52	$20.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $50.71 / $59.48 / $59.48	Professional	TC	$50.71	$59.48	$59.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.99 / $49.26 / $99.20	Professional		$36.99	$49.26	$99.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $14.60 / $27.90	Professional	26	$11.40	$14.60	$27.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.36 / $34.96 / $70.18	Professional	TC	$25.36	$34.96	$70.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.10 / $42.99 / $100.99	Professional		$34.10	$42.99	$100.99
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.74 / $30.02	Professional	26	$10.00	$12.74	$30.02
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $30.18 / $77.75	Professional	TC	$23.86	$30.18	$77.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.45 / $49.28 / $103.06	Professional		$32.45	$49.28	$103.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $13.57 / $29.20	Professional	26	$9.49	$13.57	$29.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.25 / $35.88 / $79.40	Professional	TC	$23.25	$35.88	$79.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $51.07 / $68.94	Professional		$30.83	$51.07	$68.94
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.25 / $11.91 / $16.07	Professional	26	$9.25	$11.91	$16.07
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $39.15 / $52.87	Professional	TC	$21.58	$39.15	$52.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $50.74 / $84.27	Professional		$37.50	$50.74	$84.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $14.29 / $22.62	Professional	26	$10.55	$14.29	$22.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.33 / $45.35 / $73.51	Professional	TC	$31.33	$45.35	$73.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $252.05 / $252.05 / $330.53	Professional		$252.05	$252.05	$330.53
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $92.47 / $92.47 / $92.47	Professional	26	$92.47	$92.47	$92.47
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $226.00 / $226.00 / $244.43	Professional	TC	$226.00	$226.00	$244.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $32.34 / $32.34	Professional		$31.65	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.29 / $54.52 / $105.12	Professional		$33.29	$54.52	$105.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.51 / $13.29 / $29.10	Professional	26	$9.51	$13.29	$29.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $35.67 / $75.26	Professional	TC	$23.38	$35.67	$75.26
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $127.56 / $127.56 / $127.56	Professional		$127.56	$127.56	$127.56
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $37.96 / $37.96	Professional	26	$37.96	$37.96	$37.96
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $89.60 / $89.60 / $89.60	Professional	TC	$89.60	$89.60	$89.60
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $56.78 / $83.93	Professional		$41.30	$56.78	$83.93
United Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $40.54 / $96.59	Professional		$29.27	$40.54	$96.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $12.28 / $34.15	Professional	26	$8.57	$12.28	$34.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $29.78 / $81.98	Professional	TC	$21.60	$29.78	$81.98