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 / $71.81	Facility	26	$9.98	$10.47	$71.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $46.39 / $213.56	Professional		$38.49	$46.39	$213.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.41 / $10.73 / $31.54	Professional	26	$9.41	$10.73	$31.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.29 / $35.09 / $97.55	Professional	TC	$28.29	$35.09	$97.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $58.73 / $239.21	Professional		$36.86	$58.73	$239.21
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $9.36 / $20.37	Professional	26	$8.69	$9.36	$20.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $57.63 / $116.77	Professional		$42.62	$57.63	$116.77
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $14.60 / $29.74	Professional	26	$11.46	$14.60	$29.74
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.60 / $43.40 / $87.34	Professional	TC	$31.60	$43.40	$87.34
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $49.73 / $116.33	Professional		$38.85	$49.73	$116.33
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $12.74 / $30.45	Professional	26	$10.00	$12.74	$30.45
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.80 / $37.09 / $98.79	Professional	TC	$28.80	$37.09	$98.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.77 / $57.47 / $120.66	Professional		$36.77	$57.47	$120.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $13.97 / $30.20	Professional	26	$9.69	$13.97	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.02 / $43.40 / $91.12	Professional	TC	$27.02	$43.40	$91.12
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $35.11 / $58.20 / $78.56	Professional		$35.11	$58.20	$78.56
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.48 / $13.07 / $17.64	Professional	26	$9.48	$13.07	$17.64
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $45.13 / $60.93	Professional	TC	$25.63	$45.13	$60.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $57.73 / $95.88	Professional		$42.67	$57.73	$95.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.56 / $15.68 / $24.83	Professional	26	$11.56	$15.68	$24.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.10 / $52.25 / $84.71	Professional	TC	$36.10	$52.25	$84.71
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.45 / $103.00 / $103.00	Facility	26	$29.45	$103.00	$103.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $286.68 / $286.68 / $375.30	Professional		$286.68	$286.68	$375.30
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.32 / $107.32 / $107.32	Professional	26	$107.32	$107.32	$107.32
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $267.00 / $267.00 / $281.25	Professional	TC	$267.00	$267.00	$281.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $36.04	Professional		$32.34	$32.34	$36.04
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $63.01 / $119.50	Professional		$38.90	$63.01	$119.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.92 / $13.68 / $29.10	Professional	26	$9.92	$13.68	$29.10
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.15 / $43.25 / $87.98	Professional	TC	$27.15	$43.25	$87.98
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $143.09 / $143.09 / $143.09	Professional		$143.09	$143.09	$143.09
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.26 / $40.26 / $40.26	Professional	26	$40.26	$40.26	$40.26
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $102.82 / $102.82 / $102.82	Professional	TC	$102.82	$102.82	$102.82
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $64.70 / $98.27	Professional		$47.06	$64.70	$98.27
United Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $47.48 / $119.91	Professional		$34.68	$47.48	$119.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $12.63 / $28.58	Professional	26	$8.57	$12.63	$28.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.00 / $34.72 / $105.05	Professional	TC	$27.00	$34.72	$105.05