Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $12.30 / $57.54	Facility	26	$7.94	$12.30	$57.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $91.20 / $199.53	Facility	TC	$26.92	$91.20	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $151.36	Professional		$20.89	$38.90	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $42.66	Professional	26	$7.94	$12.88	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $91.20	Professional	TC	$18.20	$25.70	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $26.30 / $51.29	Professional		$22.39	$26.30	$51.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $16.60 / $21.38	Professional	26	$8.71	$16.60	$21.38
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $26.92 / $50.12	Professional	TC	$26.92	$26.92	$50.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $61.66 / $102.33	Professional		$37.15	$61.66	$102.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.20 / $29.51	Professional	26	$11.75	$18.20	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $43.65 / $74.13	Professional	TC	$28.18	$43.65	$74.13
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $91.20	Professional		$31.62	$45.71	$91.20
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.07 / $5.75 / $14.45	Professional	26	$4.07	$5.75	$14.45
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $39.81 / $74.13	Professional	TC	$28.18	$39.81	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $38.90 / $75.86	Professional		$26.92	$38.90	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.02 / $22.91	Professional	26	$7.94	$12.02	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $27.54 / $56.23	Professional	TC	$18.62	$27.54	$56.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $44.67 / $60.26	Professional		$26.30	$44.67	$60.26
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $14.13	Professional	26	$8.13	$10.47	$14.13
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $34.67 / $46.77	Professional	TC	$18.20	$34.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $70.79	Professional		$33.11	$42.66	$70.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $19.50	Professional	26	$9.12	$12.02	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $64.57	Professional	TC	$28.84	$37.15	$64.57
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $85.11	Facility	26	$70.79	$70.79	$85.11
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	TC	$151.36	$151.36	$151.36
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $281.84	Professional		$208.93	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $72.44 / $72.44	Professional	26	$57.54	$72.44	$72.44
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $208.93 / $208.93	Professional	TC	$151.36	$208.93	$208.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $37.15	Professional		$10.72	$32.36	$37.15
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Providence Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $83.18	Professional		$26.92	$41.69	$83.18
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $21.88	Professional	26	$7.94	$11.48	$21.88
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $26.30 / $54.95	Professional	TC	$18.62	$26.30	$54.95
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $30.90	Professional	26	$30.90	$30.90	$30.90
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	TC	$74.13	$74.13	$74.13
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $38.02 / $47.86	Professional		$26.30	$38.02	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $67.61	Professional		$23.44	$32.36	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.77 / $19.50	Professional	26	$7.41	$9.77	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $22.39 / $48.98	Professional	TC	$15.85	$22.39	$48.98