Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.48 / $7.84 / $46.81	Facility	26	$7.48	$7.84	$46.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.06 / $39.65 / $133.00	Professional		$24.06	$39.65	$133.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $9.83 / $40.88	Professional	26	$7.03	$9.83	$40.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $14.06 / $163.80 / $163.80	Professional	50	$14.06	$163.80	$163.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.66 / $14.06 / $80.87	Professional	52	$10.66	$14.06	$80.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.29 / $76.08	Professional	TC	$18.21	$22.29	$76.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.37 / $37.18 / $151.15	Professional		$23.37	$37.18	$151.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.82 / $14.48 / $17.37	Professional	26	$5.82	$14.48	$17.37
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $41.87 / $60.48 / $60.48	Professional	50	$41.87	$60.48	$60.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $34.24 / $68.95	Professional		$26.57	$34.24	$68.95
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.31 / $10.49 / $20.93	Professional	26	$8.31	$10.49	$20.93
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $35.25 / $40.25 / $58.92	Professional	50	$35.25	$40.25	$58.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $24.07 / $48.34	Professional	TC	$18.73	$24.07	$48.34
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $25.97 / $33.42 / $80.48	Professional		$25.97	$33.42	$80.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $9.40 / $22.40	Professional	26	$7.41	$9.40	$22.40
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $24.11 / $58.81	Professional	TC	$19.12	$24.11	$58.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $35.82 / $76.54	Professional		$24.24	$35.82	$76.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $9.77 / $21.43	Professional	26	$6.80	$9.77	$21.43
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $35.13 / $35.13 / $39.76	Professional	50	$35.13	$35.13	$39.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.20 / $25.84 / $58.60	Professional	TC	$17.20	$25.84	$58.60
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $36.67 / $49.50	Professional		$19.02	$36.67	$49.50
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.52 / $8.52 / $11.52	Professional	26	$5.52	$8.52	$11.52
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.50 / $28.14 / $37.99	Professional	TC	$13.50	$28.14	$37.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $36.47 / $60.59	Professional		$26.96	$36.47	$60.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.55 / $10.24 / $16.19	Professional	26	$7.55	$10.24	$16.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $32.63 / $52.88	Professional	TC	$22.51	$32.63	$52.88
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 Professional Modifier Low / Median / High Price $184.96 / $184.96 / $238.88	Professional		$184.96	$184.96	$238.88
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $62.33 / $67.13 / $67.13	Professional	26	$62.33	$67.13	$67.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $149.00 / $149.00 / $176.55	Professional	TC	$149.00	$149.00	$176.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.22 / $32.34 / $32.34	Professional		$23.22	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.61 / $38.79 / $77.27	Professional		$24.61	$38.79	$77.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $6.85 / $9.69 / $20.90	Professional	26	$6.85	$9.69	$20.90
Providence Facility/Professional Professional Modifier 52 Low / Median / High Price $31.63 / $31.63 / $33.29	Professional	52	$31.63	$31.63	$33.29
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $17.20 / $25.71 / $56.09	Professional	TC	$17.20	$25.71	$56.09
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $93.05 / $93.05 / $93.05	Professional		$93.05	$93.05	$93.05
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $26.29 / $26.29 / $26.29	Professional	26	$26.29	$26.29	$26.29
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $66.76 / $66.76 / $66.76	Professional	TC	$66.76	$66.76	$66.76
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $38.20 / $46.39	Professional		$28.54	$38.20	$46.39
United Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $30.07 / $71.44	Professional		$19.96	$30.07	$71.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $8.31 / $19.61	Professional	26	$6.08	$8.31	$19.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.20 / $21.10 / $51.58	Professional	TC	$14.20	$21.10	$51.58