Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $8.14 / $51.19	Facility	26	$7.78	$8.14	$51.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $32.81 / $150.00	Professional		$26.78	$32.81	$150.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $8.23 / $23.85	Professional	26	$7.07	$8.23	$23.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $23.82 / $61.38	Professional	TC	$19.46	$23.82	$61.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $44.28 / $180.36	Professional		$25.10	$44.28	$180.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $9.52 / $13.56	Professional	26	$5.77	$9.52	$13.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $18.62 / $18.62	Professional	TC	$18.62	$18.62	$18.62
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.62 / $37.61 / $73.50	Professional		$29.62	$37.61	$73.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.39 / $22.20	Professional	26	$8.99	$11.39	$22.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.81 / $26.84 / $54.00	Professional	TC	$20.81	$26.84	$54.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $35.40 / $88.85	Professional		$28.15	$35.40	$88.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.07 / $10.27 / $23.47	Professional	26	$8.07	$10.27	$23.47
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $25.03 / $61.16	Professional	TC	$19.85	$25.03	$61.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.41 / $39.78 / $83.63	Professional		$26.41	$39.78	$83.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $10.56 / $23.41	Professional	26	$7.36	$10.56	$23.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $28.39 / $68.73	Professional	TC	$19.19	$28.39	$68.73
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $43.91 / $59.28	Professional		$21.62	$43.91	$59.28
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $9.34 / $12.61	Professional	26	$6.49	$9.34	$12.61
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.13 / $34.57 / $46.67	Professional	TC	$15.13	$34.57	$46.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.17 / $43.53 / $72.00	Professional		$32.17	$43.53	$72.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.21 / $17.73	Professional	26	$8.23	$11.21	$17.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.66 / $40.04 / $64.93	Professional	TC	$27.66	$40.04	$64.93
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 $210.99 / $210.99 / $283.88	Professional		$210.99	$210.99	$283.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $82.56 / $82.56 / $82.56	Professional	26	$82.56	$82.56	$82.56
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $159.97 / $159.97 / $216.15	Professional	TC	$159.97	$159.97	$216.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.62 / $32.34 / $32.34	Professional		$27.62	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $43.00 / $88.05	Professional		$27.58	$43.00	$88.05
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.36 / $10.24 / $23.37	Professional	26	$7.36	$10.24	$23.37
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $28.02 / $60.67	Professional	TC	$19.89	$28.02	$60.67
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $106.22 / $106.22 / $106.22	Professional		$106.22	$106.22	$106.22
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $28.64 / $28.64	Professional	26	$28.64	$28.64	$28.64
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $77.58 / $77.58	Professional	TC	$77.58	$77.58	$77.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $43.42 / $52.72	Professional		$32.43	$43.42	$52.72
United Facility/Professional Professional Modifier Low / Median / High Price $22.17 / $33.64 / $81.61	Professional		$22.17	$33.64	$81.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.02 / $22.19	Professional	26	$6.64	$9.02	$22.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.63 / $23.46 / $59.94	Professional	TC	$15.63	$23.46	$59.94