Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.84 / $9.32 / $55.63	Facility	26	$8.84	$9.32	$55.63
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.10 / $86.98 / $250.37	Facility	TC	$23.10	$86.98	$250.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.78 / $38.53 / $135.00	Professional		$26.78	$38.53	$135.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.46 / $10.49 / $41.74	Professional	26	$8.46	$10.49	$41.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $21.68 / $88.00	Professional	TC	$18.32	$21.68	$88.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $33.67 / $47.59	Professional		$24.88	$33.67	$47.59
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.65 / $9.74 / $20.20	Professional	26	$6.65	$9.74	$20.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $55.69 / $99.87	Professional		$30.79	$55.69	$99.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $16.43 / $29.48	Professional	26	$9.44	$16.43	$29.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.41 / $39.59 / $70.53	Professional	TC	$22.41	$39.59	$70.53
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $36.06 / $96.14	Professional		$28.74	$36.06	$96.14
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $3.65 / $4.58 / $13.70	Professional	26	$3.65	$4.58	$13.70
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $23.90 / $31.48 / $76.87	Professional	TC	$23.90	$31.48	$76.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.83 / $39.40 / $86.00	Professional		$26.83	$39.40	$86.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.96 / $11.95 / $25.47	Professional	26	$7.96	$11.95	$25.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.88 / $28.17 / $64.63	Professional	TC	$18.88	$28.17	$64.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $26.51 / $43.34 / $58.51	Professional		$26.51	$43.34	$58.51
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.15 / $13.70	Professional	26	$8.22	$10.15	$13.70
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.29 / $33.19 / $44.81	Professional	TC	$18.29	$33.19	$44.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.67 / $43.02 / $69.09	Professional		$32.67	$43.02	$69.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.18 / $19.27	Professional	26	$8.91	$12.18	$19.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.55 / $38.46 / $62.33	Professional	TC	$26.55	$38.46	$62.33
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $72.81 / $133.13 / $133.13	Facility	TC	$72.81	$133.13	$133.13
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $208.77 / $208.77 / $280.80	Professional		$208.77	$208.77	$280.80
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.45 / $57.45 / $73.13	Professional	26	$57.45	$57.45	$73.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.32 / $151.32 / $207.68	Professional	TC	$151.32	$151.32	$207.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.52 / $32.34 / $32.34	Professional		$26.52	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $44.15 / $87.15	Professional		$27.64	$44.15	$87.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $11.75 / $25.35	Professional	26	$8.02	$11.75	$25.35
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $19.01 / $27.79 / $61.38	Professional	TC	$19.01	$27.79	$61.38
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $104.97 / $104.97 / $104.97	Professional		$104.97	$104.97	$104.97
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $30.99 / $30.99 / $30.99	Professional	26	$30.99	$30.99	$30.99
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $73.97 / $73.97 / $73.97	Professional	TC	$73.97	$73.97	$73.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.46 / $39.43 / $48.19	Professional		$34.46	$39.43	$48.19
United Facility/Professional Professional Modifier Low / Median / High Price $23.59 / $33.82 / $79.70	Professional		$23.59	$33.82	$79.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.67 / $9.74 / $23.08	Professional	26	$7.67	$9.74	$23.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.92 / $23.57 / $64.56	Professional	TC	$15.92	$23.57	$64.56