Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.27 / $17.97 / $88.94	Facility	26	$17.27	$17.97	$88.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.94 / $82.41 / $313.08	Professional		$59.94	$82.41	$313.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.06 / $17.52 / $63.35	Professional	26	$14.06	$17.52	$63.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.94 / $57.99 / $142.99	Professional	TC	$41.94	$57.99	$142.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.16 / $62.19 / $87.94	Professional		$48.16	$62.19	$87.94
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $13.93 / $32.79	Professional	26	$10.83	$13.93	$32.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.96 / $87.43 / $175.59	Professional		$60.96	$87.43	$175.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $23.70 / $44.38	Professional	26	$16.89	$23.70	$44.38
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $64.64 / $129.82	Professional	TC	$43.65	$64.64	$129.82
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $60.59 / $79.20 / $187.48	Professional		$60.59	$79.20	$187.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $19.27 / $46.68	Professional	26	$15.16	$19.27	$46.68
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $46.51 / $59.74 / $143.12	Professional	TC	$46.51	$59.74	$143.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.77 / $85.56 / $176.74	Professional		$56.77	$85.56	$176.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $21.06 / $42.35	Professional	26	$13.35	$21.06	$42.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.10 / $63.69 / $134.04	Professional	TC	$42.10	$63.69	$134.04
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $80.30 / $108.41	Professional		$52.91	$80.30	$108.41
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $16.35 / $22.07	Professional	26	$13.23	$16.35	$22.07
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.68 / $63.94 / $86.32	Professional	TC	$39.68	$63.94	$86.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.74 / $79.01 / $127.54	Professional		$58.74	$79.01	$127.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.44 / $19.62 / $31.06	Professional	26	$14.44	$19.62	$31.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.15 / $73.98 / $119.97	Professional	TC	$51.15	$73.98	$119.97
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $49.08 / $126.00 / $126.00	Facility	26	$49.08	$126.00	$126.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $399.42 / $399.42 / $516.67	Professional		$399.42	$399.42	$516.67
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.90 / $151.90 / $151.90	Professional	26	$151.90	$151.90	$151.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $307.58 / $307.58 / $397.20	Professional	TC	$307.58	$307.58	$397.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $52.19	Professional		$32.34	$32.34	$52.19
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $96.21 / $173.96	Professional		$56.78	$96.21	$173.96
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.81 / $20.81 / $42.35	Professional	26	$13.81	$20.81	$42.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $41.97 / $63.69 / $132.49	Professional	TC	$41.97	$63.69	$132.49
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $198.14 / $198.14 / $198.14	Professional		$198.14	$198.14	$198.14
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $49.63 / $49.63 / $49.63	Professional	26	$49.63	$49.63	$49.63
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $148.51 / $148.51 / $148.51	Professional	TC	$148.51	$148.51	$148.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $64.94 / $89.29 / $149.04	Professional		$64.94	$89.29	$149.04
United Facility/Professional Professional Modifier Low / Median / High Price $52.01 / $67.39 / $151.69	Professional		$52.01	$67.39	$151.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $17.07 / $48.45	Professional	26	$13.07	$17.07	$48.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.94 / $50.48 / $114.77	Professional	TC	$38.94	$50.48	$114.77