Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.48 / $8.86 / $49.25	Facility	26	$7.48	$8.86	$49.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.30 / $38.70 / $132.13	Professional		$24.30	$38.70	$132.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.86 / $43.09	Professional	26	$7.03	$10.86	$43.09
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $86.52 / $99.89 / $204.00	Professional	50	$86.52	$99.89	$204.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $24.03 / $89.96	Professional	TC	$18.82	$24.03	$89.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.39 / $33.07 / $59.15	Professional		$29.39	$33.07	$59.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.90 / $9.15 / $16.32	Professional	26	$5.90	$9.15	$16.32
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $100.77 / $100.77 / $100.77	Professional	50	$100.77	$100.77	$100.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.27 / $36.54 / $72.06	Professional		$28.27	$36.54	$72.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $10.56 / $21.93	Professional	26	$8.44	$10.56	$21.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $42.55 / $62.07	Professional	50	$38.02	$42.55	$62.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $26.13 / $51.03	Professional	TC	$20.07	$26.13	$51.03
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $27.10 / $34.07 / $85.81	Professional		$27.10	$34.07	$85.81
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.86 / $22.76	Professional	26	$7.75	$9.86	$22.76
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $24.11 / $59.14	Professional	TC	$19.12	$24.11	$59.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.68 / $38.42 / $81.81	Professional		$25.68	$38.42	$81.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $10.02 / $22.27	Professional	26	$7.20	$10.02	$22.27
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.85 / $37.85 / $42.89	Professional	50	$37.85	$37.85	$42.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $27.71 / $64.84	Professional	TC	$18.82	$27.71	$64.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $42.64 / $57.56	Professional		$20.78	$42.64	$57.56
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.99 / $12.14	Professional	26	$6.03	$8.99	$12.14
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.75 / $33.65 / $45.43	Professional	TC	$14.75	$33.65	$45.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.23 / $42.25 / $70.17	Professional		$31.23	$42.25	$70.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.90 / $10.79 / $17.07	Professional	26	$7.90	$10.79	$17.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.99 / $63.20	Professional	TC	$26.92	$38.99	$63.20
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $22.09 / $100.00 / $100.00	Facility	26	$22.09	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $206.66 / $206.66 / $275.70	Professional		$206.66	$206.66	$275.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.26 / $79.26 / $79.26	Professional	26	$79.26	$79.26	$79.26
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $161.00 / $161.00 / $210.53	Professional	TC	$161.00	$161.00	$210.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $32.34 / $32.34	Professional		$26.89	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.19 / $9.19 / $9.19	Facility	26	$9.19	$9.19	$9.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.85 / $41.58 / $86.26	Professional		$26.85	$41.58	$86.26
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $9.92 / $21.98	Professional	26	$7.25	$9.92	$21.98
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.36 / $27.27 / $59.54	Professional	TC	$19.36	$27.27	$59.54
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $103.87 / $103.87 / $103.87	Professional		$103.87	$103.87	$103.87
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $27.49 / $27.49 / $27.49	Professional	26	$27.49	$27.49	$27.49
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $76.38 / $76.38 / $76.38	Professional	TC	$76.38	$76.38	$76.38
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $41.73 / $50.67	Professional		$31.17	$41.73	$50.67
United Facility/Professional Professional Modifier Low / Median / High Price $20.74 / $31.76 / $79.47	Professional		$20.74	$31.76	$79.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $8.66 / $20.54	Professional	26	$6.36	$8.66	$20.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.05 / $23.29 / $59.42	Professional	TC	$15.05	$23.29	$59.42