Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.73 / $10.66 / $67.88	Facility	26	$8.73	$10.66	$67.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $44.11 / $169.86	Professional		$31.42	$44.11	$169.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $11.08 / $46.00	Professional	26	$8.22	$11.08	$46.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.19 / $28.90 / $109.37	Professional	TC	$23.19	$28.90	$109.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $51.66 / $69.72	Professional		$32.47	$51.66	$69.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $13.12 / $24.24	Professional	26	$8.10	$13.12	$24.24
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.85 / $52.36 / $52.36	Professional	TC	$33.85	$52.36	$52.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $44.03 / $87.15	Professional		$34.22	$44.03	$87.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.10 / $12.80 / $24.96	Professional	26	$10.10	$12.80	$24.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $31.99 / $64.45	Professional	TC	$24.57	$31.99	$64.45
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $41.11 / $100.00	Professional		$33.07	$41.11	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.69 / $11.07 / $26.64	Professional	26	$8.69	$11.07	$26.64
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $29.60 / $72.48	Professional	TC	$23.50	$29.60	$72.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.42 / $46.54 / $98.94	Professional		$31.42	$46.54	$98.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $12.37 / $27.55	Professional	26	$8.52	$12.37	$27.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.72 / $34.01 / $78.33	Professional	TC	$22.72	$34.01	$78.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $51.07 / $68.94	Professional		$29.57	$51.07	$68.94
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.91 / $16.07	Professional	26	$7.98	$11.91	$16.07
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.59 / $39.15 / $52.87	Professional	TC	$21.59	$39.15	$52.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.50 / $50.74 / $85.66	Professional		$37.50	$50.74	$85.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $14.29 / $22.62	Professional	26	$10.55	$14.29	$22.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.33 / $45.35 / $73.51	Professional	TC	$31.33	$45.35	$73.51
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	26	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $252.05 / $252.05 / $330.53	Professional		$252.05	$252.05	$330.53
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 $183.85 / $183.85 / $244.43	Professional	TC	$183.85	$183.85	$244.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $32.34 / $32.34	Professional		$31.65	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $50.83 / $105.12	Professional		$32.63	$50.83	$105.12
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $11.95 / $25.61	Professional	26	$8.86	$11.95	$25.61
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $22.72 / $33.57 / $73.75	Professional	TC	$22.72	$33.57	$73.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $126.36 / $126.36 / $126.36	Professional		$126.36	$126.36	$126.36
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $37.96 / $37.96	Professional	26	$37.96	$37.96	$37.96
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $88.40 / $88.40 / $88.40	Professional	TC	$88.40	$88.40	$88.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $56.78 / $74.52	Professional		$41.30	$56.78	$74.52
United Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $38.61 / $96.54	Professional		$26.43	$38.61	$96.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $11.91 / $31.07	Professional	26	$7.47	$11.91	$31.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.61 / $29.04 / $68.31	Professional	TC	$19.61	$29.04	$68.31