Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.55 / $8.81 / $53.68	Facility	26	$8.55	$8.81	$53.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $36.17 / $151.59	Professional		$23.24	$36.17	$151.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $9.48 / $39.52	Professional	26	$7.95	$9.48	$39.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $52.94 / $52.94 / $52.94	Professional	50	$52.94	$52.94	$52.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.46 / $22.16 / $88.92	Professional	TC	$14.46	$22.16	$88.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $23.99 / $42.83	Professional		$19.80	$23.99	$42.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.43 / $8.26 / $15.07	Professional	26	$6.43	$8.26	$15.07
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.98 / $17.98 / $17.98	Professional	TC	$17.98	$17.98	$17.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $36.53 / $71.87	Professional		$26.65	$36.53	$71.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $11.40 / $22.20	Professional	26	$9.15	$11.40	$22.20
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $29.58 / $40.11 / $51.28	Professional	50	$29.58	$40.11	$51.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.22 / $25.33 / $49.74	Professional	TC	$17.22	$25.33	$49.74
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.23 / $37.89 / $90.95	Professional		$29.23	$37.89	$90.95
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.41 / $10.74 / $24.88	Professional	26	$8.41	$10.74	$24.88
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $20.94 / $26.40 / $60.84	Professional	TC	$20.94	$26.40	$60.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.48 / $36.57 / $72.52	Professional		$24.48	$36.57	$72.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $10.91 / $24.58	Professional	26	$7.85	$10.91	$24.58
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.47 / $41.47 / $47.09	Professional	50	$41.47	$41.47	$47.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.70 / $26.14 / $53.75	Professional	TC	$16.70	$26.14	$53.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $30.60 / $41.31	Professional		$21.39	$30.60	$41.31
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.20 / $9.80 / $13.23	Professional	26	$6.20	$9.80	$13.23
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $20.80 / $28.08	Professional	TC	$15.19	$20.80	$28.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $22.65 / $30.60 / $52.02	Professional		$22.65	$30.60	$52.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.59 / $11.76 / $18.61	Professional	26	$8.59	$11.76	$18.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $24.14 / $39.11	Professional	TC	$16.64	$24.14	$39.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $100.00 / $100.00	Facility	26	$24.54	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $203.00 / $203.00 / $203.00	Professional		$203.00	$203.00	$203.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $84.21 / $84.21 / $84.21	Professional	26	$84.21	$84.21	$84.21
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.33 / $165.00 / $165.00	Professional	TC	$131.33	$165.00	$165.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.59 / $32.34 / $32.34	Professional		$18.59	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $9.96 / $9.96	Facility	26	$9.96	$9.96	$9.96
Providence Facility/Professional Professional Modifier Low / Median / High Price $25.09 / $40.69 / $72.14	Professional		$25.09	$40.69	$72.14
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.85 / $10.78 / $24.41	Professional	26	$7.85	$10.78	$24.41
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $26.14 / $53.75	Professional	TC	$16.82	$26.14	$53.75
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $91.80 / $91.80 / $91.80	Professional		$91.80	$91.80	$91.80
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $29.84 / $29.84 / $29.84	Professional	26	$29.84	$29.84	$29.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $61.95 / $61.95 / $61.95	Professional	TC	$61.95	$61.95	$61.95
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $24.74 / $34.01 / $60.45	Professional		$24.74	$34.01	$60.45
United Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $31.35 / $79.33	Professional		$21.60	$31.35	$79.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.01 / $23.16	Professional	26	$6.92	$10.01	$23.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.35 / $21.49 / $52.42	Professional	TC	$15.35	$21.49	$52.42