Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $27.54 / $93.33	Facility	26	$14.13	$27.54	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $61.66 / $199.53	Professional		$34.67	$61.66	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $56.23	Professional	26	$12.88	$19.95	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $41.69 / $109.65	Professional	TC	$20.89	$41.69	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $75.86 / $77.62	Professional		$33.88	$75.86	$77.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $26.92 / $34.67	Professional	26	$12.59	$26.92	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $93.33 / $169.82	Professional		$45.71	$93.33	$169.82
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $28.18 / $70.79	Professional	26	$16.98	$28.18	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $72.44 / $125.89	Professional	TC	$28.84	$72.44	$125.89
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $190.55	Professional		$41.69	$64.57	$190.55
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.44 / $41.69	Professional	26	$17.78	$23.44	$41.69
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $38.90 / $151.36	Professional	TC	$24.55	$38.90	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $112.20	Professional		$33.88	$64.57	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.50 / $38.02	Professional	26	$13.18	$19.50	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $44.67 / $81.28	Professional	TC	$20.89	$44.67	$81.28
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $54.95 / $74.13	Professional		$33.11	$54.95	$74.13
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.38 / $23.44	Professional	26	$13.49	$17.38	$23.44
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $37.15 / $50.12	Professional	TC	$19.50	$37.15	$50.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $97.72	Professional		$40.74	$51.29	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $32.36	Professional	26	$15.14	$19.95	$32.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $39.81 / $70.79	Professional	TC	$30.90	$39.81	$70.79
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 $346.74 / $346.74 / $389.05	Professional		$346.74	$346.74	$389.05
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $123.03	Professional	26	$102.33	$123.03	$123.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $302.00	Professional	TC	$257.04	$257.04	$302.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $32.36 / $46.77	Professional		$18.20	$32.36	$46.77
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.72 / $17.38 / $24.55	Facility	26	$3.72	$17.38	$24.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $67.61 / $107.15	Professional		$34.67	$67.61	$107.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $36.31	Professional	26	$13.18	$19.05	$36.31
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $45.71 / $77.62	Professional	TC	$20.89	$45.71	$77.62
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Professional		$131.83	$131.83	$131.83
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Professional	26	$52.48	$52.48	$52.48
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	TC	$81.28	$81.28	$81.28
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $93.33	Professional		$44.67	$61.66	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $102.33	Professional		$38.02	$51.29	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $16.22 / $32.36	Professional	26	$11.75	$16.22	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $75.86	Professional	TC	$22.39	$33.11	$75.86