Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.45 / $10.84 / $74.25	Facility	26	$10.45	$10.84	$74.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.90 / $47.10 / $208.00	Professional		$36.90	$47.10	$208.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $12.28 / $43.81	Professional	26	$9.75	$12.28	$43.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.85 / $33.56 / $86.59	Professional	TC	$26.85	$33.56	$86.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $42.40 / $224.48	Professional		$35.02	$42.40	$224.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $12.95 / $27.40	Professional	26	$8.93	$12.95	$27.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.81 / $54.81 / $54.81	Professional	TC	$54.81	$54.81	$54.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.82 / $49.91 / $97.99	Professional		$36.82	$49.91	$97.99
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.25 / $14.15 / $29.30	Professional	26	$11.25	$14.15	$29.30
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.65 / $35.76 / $70.78	Professional	TC	$25.65	$35.76	$70.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $36.89 / $47.72 / $109.38	Professional		$36.89	$47.72	$109.38
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $12.81 / $31.96	Professional	26	$10.02	$12.81	$31.96
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $27.70 / $35.40 / $90.67	Professional	TC	$27.70	$35.40	$90.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $52.12 / $112.48	Professional		$34.63	$52.12	$112.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $14.09 / $31.00	Professional	26	$9.80	$14.09	$31.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $37.90 / $84.57	Professional	TC	$24.83	$37.90	$84.57
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $31.55 / $54.53 / $73.62	Professional		$31.55	$54.53	$73.62
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $13.53 / $18.27	Professional	26	$8.52	$13.53	$18.27
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $40.99 / $55.34	Professional	TC	$23.03	$40.99	$55.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.04 / $54.18 / $89.98	Professional		$40.04	$54.18	$89.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.92 / $16.23 / $25.70	Professional	26	$11.92	$16.23	$25.70
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 $271.52 / $271.52 / $352.65	Professional		$271.52	$271.52	$352.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.41 / $97.41 / $97.41	Professional	26	$97.41	$97.41	$97.41
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $210.00 / $210.00 / $255.75	Professional	TC	$210.00	$210.00	$255.75
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 $13.86 / $13.86 / $13.86	Facility	26	$13.86	$13.86	$13.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $56.95 / $113.21	Professional		$35.43	$56.95	$113.21
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $13.71 / $29.56	Professional	26	$9.96	$13.71	$29.56
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.83 / $37.53 / $81.41	Professional	TC	$24.83	$37.53	$81.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $134.68 / $134.68 / $134.68	Professional		$134.68	$134.68	$134.68
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $41.46 / $41.46 / $41.46	Professional	26	$41.46	$41.46	$41.46
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $93.21 / $93.21 / $93.21	Professional	TC	$93.21	$93.21	$93.21
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $60.63 / $76.94	Professional		$44.10	$60.63	$76.94
United Facility/Professional Professional Modifier Low / Median / High Price $28.99 / $43.91 / $136.12	Professional		$28.99	$43.91	$136.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $12.99 / $36.11	Professional	26	$8.57	$12.99	$36.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.60 / $32.24 / $75.22	Professional	TC	$21.60	$32.24	$75.22