Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $11.22 / $29.51	Facility	26	$7.94	$11.22	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $169.82	Professional		$30.20	$47.86	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.75 / $34.67	Professional	26	$7.08	$11.75	$34.67
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $40.74 / $58.88	Professional	50	$38.90	$40.74	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $131.83	Professional	TC	$22.39	$33.11	$131.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $42.66 / $60.26	Professional		$27.54	$42.66	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $13.80 / $15.85	Professional	26	$6.92	$13.80	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $28.84 / $67.61	Professional	TC	$25.70	$28.84	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $89.13	Professional		$32.36	$43.65	$89.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $12.59 / $23.99	Professional	26	$9.33	$12.59	$23.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $41.69 / $54.95 / $85.11	Professional	50	$41.69	$54.95	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.20 / $72.44	Professional	TC	$22.91	$30.20	$72.44
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $52.48 / $97.72	Professional		$39.81	$52.48	$97.72
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $23.44	Professional	26	$9.77	$13.18	$23.44
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $39.81 / $75.86	Professional	TC	$30.20	$39.81	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $87.10	Professional		$29.51	$44.67	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.96 / $21.38	Professional	26	$7.59	$10.96	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $32.36 / $74.13	Professional	TC	$20.89	$32.36	$74.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $57.54 / $77.62	Professional		$19.05	$57.54	$77.62
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.37 / $9.77 / $13.18	Professional	26	$4.37	$9.77	$13.18
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $46.77 / $63.10	Professional	TC	$14.79	$46.77	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $89.13	Professional		$41.69	$53.70	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $18.20	Professional	26	$8.51	$11.22	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $51.29 / $85.11	Professional	TC	$38.90	$51.29	$85.11
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $338.84	Professional		$263.03	$338.84	$338.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $83.18	Professional	26	$67.61	$67.61	$83.18
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $269.15 / $269.15	Professional	TC	$208.93	$269.15	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $33.11 / $44.67	Professional		$10.00	$33.11	$44.67
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $100.00	Professional		$29.51	$46.77	$100.00
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.47 / $20.89	Professional	26	$7.41	$10.47	$20.89
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $67.61	Professional	TC	$20.89	$30.20	$67.61
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	26	$28.84	$28.84	$28.84
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $100.00 / $100.00	Professional	TC	$100.00	$100.00	$100.00
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $46.77 / $52.48	Professional		$28.84	$46.77	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.90 / $83.18	Professional		$23.44	$38.90	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $18.20	Professional	26	$6.46	$9.12	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $30.20 / $66.07	Professional	TC	$16.22	$30.20	$66.07