Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.75 / $11.14 / $65.94	Facility	26	$10.75	$11.14	$65.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $52.18 / $207.54	Professional		$37.72	$52.18	$207.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $11.11 / $48.26	Professional	26	$9.57	$11.11	$48.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.91 / $41.42 / $159.78	Professional	TC	$26.91	$41.42	$159.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.14 / $53.47 / $83.61	Professional		$41.14	$53.47	$83.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $17.44 / $25.63	Professional	26	$8.53	$17.44	$25.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $60.19 / $116.68	Professional		$42.83	$60.19	$116.68
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.61 / $14.60 / $28.10	Professional	26	$11.61	$14.60	$28.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.44 / $45.69 / $86.60	Professional	TC	$31.44	$45.69	$86.60
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $51.28 / $124.85	Professional		$39.00	$51.28	$124.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.34 / $13.21 / $30.70	Professional	26	$10.34	$13.21	$30.70
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $38.04 / $100.00	Professional	TC	$29.34	$38.04	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.52 / $57.06 / $114.69	Professional		$36.52	$57.06	$114.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $13.59 / $30.09	Professional	26	$9.78	$13.59	$30.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.16 / $43.27 / $86.44	Professional	TC	$26.16	$43.27	$86.44
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $53.01 / $71.56	Professional		$34.61	$53.01	$71.56
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $12.02 / $16.23	Professional	26	$9.34	$12.02	$16.23
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.27 / $40.99 / $55.34	Professional	TC	$25.27	$40.99	$55.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $52.57 / $91.00	Professional		$38.85	$52.57	$91.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $14.42 / $22.82	Professional	26	$10.58	$14.42	$22.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $47.48 / $76.95	Professional	TC	$32.79	$47.48	$76.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.90 / $100.00 / $100.00	Facility	26	$31.90	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $262.94 / $264.31 / $342.08	Professional		$262.94	$264.31	$342.08
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $117.24 / $117.24 / $117.24	Professional	26	$117.24	$117.24	$117.24
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.73 / $207.78 / $255.75	Professional	TC	$201.73	$207.78	$255.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $33.11	Professional		$32.34	$32.34	$33.11
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $64.06 / $113.64	Professional		$36.61	$64.06	$113.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.82 / $13.50 / $29.41	Professional	26	$9.82	$13.50	$29.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $26.16 / $43.76 / $85.96	Professional	TC	$26.16	$43.76	$85.96
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $131.22 / $131.22 / $131.22	Professional		$131.22	$131.22	$131.22
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 $94.41 / $94.41 / $94.41	Professional	TC	$94.41	$94.41	$94.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.87 / $58.95 / $84.39	Professional		$42.87	$58.95	$84.39
United Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $45.76 / $105.62	Professional		$36.09	$45.76	$105.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $11.91 / $35.97	Professional	26	$8.52	$11.91	$35.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.38 / $33.02 / $82.41	Professional	TC	$27.38	$33.02	$82.41