Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.48 / $67.61	Facility	26	$8.13	$11.48	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $56.23 / $181.97	Professional		$31.62	$56.23	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.85 / $47.86	Professional	26	$8.51	$15.85	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $128.82	Professional	TC	$22.91	$33.88	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $89.13	Professional		$28.84	$43.65	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $17.38 / $23.99	Professional	26	$10.00	$17.38	$23.99
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $52.48	Professional	TC	$26.30	$30.20	$52.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $47.86 / $97.72	Professional		$36.31	$47.86	$97.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $27.54	Professional	26	$10.23	$13.80	$27.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $34.67 / $69.18	Professional	TC	$25.70	$34.67	$69.18
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $50.12 / $100.00	Professional		$37.15	$50.12	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.18 / $25.70	Professional	26	$10.23	$13.18	$25.70
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $37.15 / $75.86	Professional	TC	$26.30	$37.15	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $46.77 / $89.13	Professional		$31.62	$46.77	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.30 / $25.70	Professional	26	$8.32	$12.30	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $67.61	Professional	TC	$22.91	$33.88	$67.61
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $69.18	Professional		$29.51	$51.29	$69.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $16.22	Professional	26	$7.94	$12.02	$16.22
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $39.81 / $53.70	Professional	TC	$21.38	$39.81	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $87.10	Professional		$38.02	$48.98	$87.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.80 / $22.39	Professional	26	$10.23	$13.80	$22.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $42.66 / $74.13	Professional	TC	$33.11	$42.66	$74.13
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $331.13	Professional		$251.19	$331.13	$331.13
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	26	$97.72	$97.72	$97.72
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $245.47 / $245.47	Professional	TC	$181.97	$245.47	$245.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $32.36 / $44.67	Professional		$12.88	$32.36	$44.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $48.98 / $97.72	Professional		$31.62	$48.98	$97.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.75 / $23.44	Professional	26	$8.32	$11.75	$23.44
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $32.36 / $64.57	Professional	TC	$22.39	$32.36	$64.57
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	26	$38.02	$38.02	$38.02
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	TC	$89.13	$89.13	$89.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $57.54 / $74.13	Professional		$42.66	$57.54	$74.13
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.90 / $81.28	Professional		$26.30	$38.90	$81.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $23.44	Professional	26	$7.41	$12.02	$23.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.92 / $58.88	Professional	TC	$19.50	$26.92	$58.88