Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.87 / $6.93 / $38.45	Facility	26	$5.87	$6.93	$38.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.32 / $115.61 / $369.74	Facility	TC	$27.32	$115.61	$369.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $41.54 / $152.29	Professional		$25.30	$41.54	$152.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $8.01 / $29.70	Professional	26	$5.53	$8.01	$29.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $27.32 / $101.00	Professional	TC	$20.96	$27.32	$101.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.89 / $31.21 / $64.54	Professional		$23.89	$31.21	$64.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.66 / $7.85 / $14.11	Professional	26	$4.66	$7.85	$14.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.96 / $46.96 / $46.96	Professional	TC	$46.96	$46.96	$46.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.26 / $33.79 / $67.88	Professional		$25.26	$33.79	$67.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.64 / $17.05	Professional	26	$6.76	$8.64	$17.05
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.61 / $25.72 / $52.05	Professional	TC	$18.61	$25.72	$52.05
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $35.11 / $85.85	Professional		$27.31	$35.11	$85.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $6.11 / $7.73 / $17.76	Professional	26	$6.11	$7.73	$17.76
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.67 / $27.31 / $66.67	Professional	TC	$21.67	$27.31	$66.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $35.52 / $78.64	Professional		$23.95	$35.52	$78.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.61 / $8.02 / $17.61	Professional	26	$5.61	$8.02	$17.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.19 / $27.71 / $63.41	Professional	TC	$18.19	$27.71	$63.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $15.59 / $37.90 / $51.18	Professional		$15.59	$37.90	$51.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.59 / $7.01 / $9.46	Professional	26	$3.59	$7.01	$9.46
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.00 / $30.90 / $41.72	Professional	TC	$12.00	$30.90	$41.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.74 / $37.54 / $60.16	Professional		$27.74	$37.54	$60.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $8.41 / $13.31	Professional	26	$6.21	$8.41	$13.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $35.81 / $58.03	Professional	TC	$24.72	$35.81	$58.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.18 / $100.00 / $100.00	Facility	26	$17.18	$100.00	$100.00
Lucent Health Facility/Professional Facility Modifier TC Low / Median / High Price $100.00 / $123.98 / $123.98	Facility	TC	$100.00	$123.98	$123.98
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $187.25 / $187.25 / $245.33	Professional		$187.25	$187.25	$245.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.49 / $54.49 / $54.49	Professional	26	$54.49	$54.49	$54.49
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $146.99 / $146.99 / $193.58	Professional	TC	$146.99	$146.99	$193.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.42 / $32.34 / $32.34	Professional		$25.42	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Providence Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Providence Facility/Professional Professional Modifier Low / Median / High Price $24.49 / $39.58 / $78.64	Professional		$24.49	$39.58	$78.64
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $5.65 / $7.81 / $17.18	Professional	26	$5.65	$7.81	$17.18
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $27.71 / $63.41	Professional	TC	$18.27	$27.71	$63.41
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $93.20 / $93.20 / $93.20	Professional		$93.20	$93.20	$93.20
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $21.63 / $21.63	Professional	26	$21.63	$21.63	$21.63
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $71.56 / $71.56 / $71.56	Professional	TC	$71.56	$71.56	$71.56
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $34.49 / $42.15	Professional		$23.38	$34.49	$42.15
United Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $31.17 / $78.26	Professional		$20.47	$31.17	$78.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.98 / $6.86 / $16.07	Professional	26	$4.98	$6.86	$16.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $24.11 / $58.03	Professional	TC	$15.49	$24.11	$58.03