Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.90 / $9.22 / $51.74	Facility	26	$8.90	$9.22	$51.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $44.25 / $154.00	Professional		$30.51	$44.25	$154.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $8.92 / $34.31	Professional	26	$7.79	$8.92	$34.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.24 / $39.24 / $59.06	Professional	50	$39.24	$39.24	$59.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.74 / $88.11	Professional	TC	$22.26	$27.74	$88.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.71 / $72.88 / $72.88	Professional		$29.71	$72.88	$72.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.90 / $10.56 / $18.64	Professional	26	$6.90	$10.56	$18.64
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $58.97 / $58.97 / $58.97	Professional	TC	$58.97	$58.97	$58.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.87 / $40.22 / $80.83	Professional		$30.87	$40.22	$80.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.99 / $11.61 / $22.70	Professional	26	$8.99	$11.61	$22.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $39.49 / $48.17 / $70.95	Professional	50	$39.49	$48.17	$70.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.79 / $28.45 / $59.07	Professional	TC	$21.79	$28.45	$59.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $44.39 / $100.00	Professional		$34.72	$44.39	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $10.34 / $24.52	Professional	26	$8.10	$10.34	$24.52
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.83 / $34.17 / $74.83	Professional	TC	$26.83	$34.17	$74.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.42 / $44.48 / $101.92	Professional		$29.42	$44.48	$101.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $10.89 / $23.47	Professional	26	$7.70	$10.89	$23.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $32.89 / $85.00	Professional	TC	$21.01	$32.89	$85.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $52.74 / $71.20	Professional		$19.02	$52.74	$71.20
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $9.44 / $12.76	Professional	26	$4.37	$9.44	$12.76
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.65 / $43.29 / $58.44	Professional	TC	$14.65	$43.29	$58.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $52.01 / $83.22	Professional		$38.45	$52.01	$83.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.26 / $11.34 / $17.94	Professional	26	$8.26	$11.34	$17.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.63 / $50.12 / $81.26	Professional	TC	$34.63	$50.12	$81.26
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 $260.95 / $260.95 / $337.88	Professional		$260.95	$260.95	$337.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.95 / $83.63 / $83.63	Professional	26	$67.95	$83.63	$83.63
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $207.72 / $207.72 / $269.93	Professional	TC	$207.72	$207.72	$269.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $34.95	Professional		$32.34	$32.34	$34.95
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Providence Facility/Professional Professional Modifier Low / Median / High Price $30.43 / $50.34 / $108.72	Professional		$30.43	$50.34	$108.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.66 / $23.06	Professional	26	$7.76	$10.66	$23.06
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.11 / $31.33 / $74.68	Professional	TC	$21.11	$31.33	$74.68
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $129.12 / $129.12	Professional		$129.12	$129.12	$129.12
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.69 / $28.69 / $28.69	Professional	26	$28.69	$28.69	$28.69
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $100.42 / $100.42 / $100.42	Professional	TC	$100.42	$100.42	$100.42
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $46.39 / $58.64	Professional		$28.54	$46.39	$58.64
United Facility/Professional Professional Modifier Low / Median / High Price $23.51 / $39.34 / $99.46	Professional		$23.51	$39.34	$99.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $9.92 / $24.29	Professional	26	$7.20	$9.92	$24.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $30.32 / $87.90	Professional	TC	$16.30	$30.32	$87.90