Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.37 / $12.89 / $78.68	Facility	26	$12.37	$12.89	$78.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $46.79 / $171.00	Professional		$35.09	$46.79	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $16.43 / $61.00	Professional	26	$11.74	$16.43	$61.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $29.36 / $93.52	Professional	TC	$23.26	$29.36	$93.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $44.81 / $61.35	Professional		$40.82	$44.81	$61.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $11.11 / $23.49	Professional	26	$9.19	$11.11	$23.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $63.67 / $63.67 / $63.67	Professional	TC	$63.67	$63.67	$63.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $71.81 / $130.06	Professional		$39.93	$71.81	$130.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $22.84 / $41.71	Professional	26	$13.32	$22.84	$41.71
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.72 / $49.39 / $88.00	Professional	TC	$28.72	$49.39	$88.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $46.49 / $109.39	Professional		$35.22	$46.49	$109.39
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.63 / $5.81 / $18.44	Professional	26	$4.63	$5.81	$18.44
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $30.83 / $40.68 / $100.00	Professional	TC	$30.83	$40.68	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $51.62 / $111.35	Professional		$35.13	$51.62	$111.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.11 / $16.69 / $35.82	Professional	26	$11.11	$16.69	$35.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $35.68 / $81.66	Professional	TC	$23.87	$35.68	$81.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $55.80 / $75.33	Professional		$34.72	$55.80	$75.33
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $13.88 / $18.73	Professional	26	$11.46	$13.88	$18.73
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $41.91 / $56.58	Professional	TC	$23.26	$41.91	$56.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $55.45 / $92.10	Professional		$42.14	$55.45	$92.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.24 / $16.66 / $26.38	Professional	26	$12.24	$16.66	$26.38
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 $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $273.64 / $273.64 / $360.90	Professional		$273.64	$273.64	$360.90
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $78.91 / $78.91 / $99.45	Professional	26	$78.91	$78.91	$99.45
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.73 / $194.73 / $261.45	Professional	TC	$194.73	$194.73	$261.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $33.49	Professional		$32.34	$32.34	$33.49
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.85 / $57.80 / $114.11	Professional		$35.85	$57.80	$114.11
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $16.16 / $35.39	Professional	26	$11.25	$16.16	$35.39
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $35.26 / $78.95	Professional	TC	$24.26	$35.26	$78.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $138.22 / $138.22 / $138.22	Professional		$138.22	$138.22	$138.22
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $43.82 / $43.82	Professional	26	$43.82	$43.82	$43.82
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $94.41 / $94.41 / $94.41	Professional	TC	$94.41	$94.41	$94.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $50.76 / $62.04	Professional		$45.12	$50.76	$62.04
United Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $42.22 / $139.69	Professional		$30.97	$42.22	$139.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $14.67 / $33.06	Professional	26	$10.80	$14.67	$33.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.17 / $29.57 / $73.44	Professional	TC	$20.17	$29.57	$73.44