Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.43 / $7.13 / $44.82	Facility	26	$6.43	$7.13	$44.82
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.21 / $74.01 / $267.24	Facility	TC	$19.21	$74.01	$267.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.22 / $25.92 / $91.78	Professional		$20.22	$25.92	$91.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.68 / $32.67	Professional	26	$6.42	$7.68	$32.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.08 / $16.77 / $42.74	Professional	TC	$13.08	$16.77	$42.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.10 / $21.64 / $37.92	Professional		$19.10	$21.64	$37.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $9.57 / $12.80	Professional	26	$5.72	$9.57	$12.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.20 / $16.20 / $16.20	Professional	TC	$16.20	$16.20	$16.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $31.14 / $61.89	Professional		$22.99	$31.14	$61.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.93 / $10.00 / $19.98	Professional	26	$7.93	$10.00	$19.98
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $26.64 / $34.49 / $48.55	Professional	50	$26.64	$34.49	$48.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $14.96 / $21.07 / $41.91	Professional	TC	$14.96	$21.07	$41.91
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $21.68 / $28.00 / $65.61	Professional		$21.68	$28.00	$65.61
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $9.00 / $20.71	Professional	26	$7.09	$9.00	$20.71
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $15.10 / $19.14 / $46.51	Professional	TC	$15.10	$19.14	$46.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.55 / $30.04 / $62.54	Professional		$19.55	$30.04	$62.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.34 / $20.53	Professional	26	$6.64	$9.34	$20.53
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $31.05 / $35.06	Professional	50	$31.05	$31.05	$35.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.54 / $20.88 / $42.01	Professional	TC	$13.54	$20.88	$42.01
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $27.60 / $37.26	Professional		$17.30	$27.60	$37.26
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.88 / $8.18 / $11.04	Professional	26	$5.88	$8.18	$11.04
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.42 / $19.42 / $26.22	Professional	TC	$11.42	$19.42	$26.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $20.43 / $27.60 / $45.92	Professional		$20.43	$27.60	$45.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.22 / $9.82 / $15.53	Professional	26	$7.22	$9.82	$15.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $15.54 / $22.55 / $36.54	Professional	TC	$15.54	$22.55	$36.54
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $100.00 / $100.00	Facility	26	$19.63	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $34.36 / $100.00 / $100.00	Facility	TC	$34.36	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $172.00 / $172.00 / $182.55	Professional		$172.00	$172.00	$182.55
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.64 / $72.64 / $72.64	Professional	26	$72.64	$72.64	$72.64
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $122.85 / $148.00 / $148.00	Professional	TC	$122.85	$148.00	$148.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.88 / $32.34 / $32.34	Professional		$15.88	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $33.44 / $61.42	Professional		$20.05	$33.44	$61.42
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $9.17 / $20.02	Professional	26	$6.64	$9.17	$20.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.26 / $20.81 / $41.08	Professional	TC	$13.26	$20.81	$41.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $70.26 / $70.26 / $70.26	Professional		$70.26	$70.26	$70.26
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.13 / $25.13 / $25.13	Professional	26	$25.13	$25.13	$25.13
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $45.12 / $45.12 / $45.12	Professional	TC	$45.12	$45.12	$45.12
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $22.31 / $30.68 / $42.20	Professional		$22.31	$30.68	$42.20
United Facility/Professional Professional Modifier Low / Median / High Price $18.19 / $24.50 / $60.36	Professional		$18.19	$24.50	$60.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.81 / $7.94 / $20.18	Professional	26	$5.81	$7.94	$20.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.79 / $16.47 / $41.06	Professional	TC	$12.79	$16.47	$41.06