Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.78 / $9.76 / $87.95	Facility	26	$7.78	$9.76	$87.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $79.51 / $149.97	Professional		$38.69	$79.51	$149.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $12.95 / $47.00	Professional	26	$7.33	$12.95	$47.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.74 / $71.73 / $153.63	Professional	TC	$26.74	$71.73	$153.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.39 / $104.39 / $104.39	Professional		$104.39	$104.39	$104.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $18.59 / $33.04	Professional	26	$12.09	$18.59	$33.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.30 / $102.84 / $167.70	Professional		$50.30	$102.84	$167.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.25 / $12.36 / $23.42	Professional	26	$8.25	$12.36	$23.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.46 / $92.00 / $149.04	Professional	TC	$34.46	$92.00	$149.04
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $76.43 / $102.89 / $226.14	Professional		$76.43	$102.89	$226.14
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $10.24 / $30.10	Professional	26	$8.52	$10.24	$30.10
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $67.70 / $95.17 / $203.26	Professional	TC	$67.70	$95.17	$203.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.25 / $77.38 / $139.96	Professional		$40.25	$77.38	$139.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.30 / $12.76 / $34.09	Professional	26	$8.30	$12.76	$34.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.57 / $63.87 / $115.55	Professional	TC	$29.57	$63.87	$115.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.96 / $54.74 / $73.90	Professional		$27.96	$54.74	$73.90
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.75 / $16.50 / $22.28	Professional	26	$4.75	$16.50	$22.28
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.21 / $38.24 / $51.62	Professional	TC	$23.21	$38.24	$51.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.54 / $54.41 / $94.00	Professional		$40.54	$54.41	$94.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.63 / $19.80 / $31.02	Professional	26	$14.63	$19.80	$31.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.59 / $44.30 / $71.81	Professional	TC	$30.59	$44.30	$71.81
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 $403.43 / $475.98 / $479.78	Professional		$403.43	$475.98	$479.78
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $211.35 / $211.35 / $211.35	Professional	26	$211.35	$211.35	$211.35
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.89 / $429.40 / $429.40	Professional	TC	$367.89	$429.40	$429.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $33.51	Professional		$32.34	$32.34	$33.51
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Providence Facility/Professional Professional Modifier Low / Median / High Price $43.06 / $83.04 / $130.28	Professional		$43.06	$83.04	$130.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.39 / $12.37 / $32.43	Professional	26	$8.39	$12.37	$32.43
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $27.71 / $65.81 / $113.77	Professional	TC	$27.71	$65.81	$113.77
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $138.12 / $138.12 / $138.12	Professional		$138.12	$138.12	$138.12
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $49.72 / $49.72	Professional	26	$49.72	$49.72	$49.72
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $88.40 / $88.40 / $88.40	Professional	TC	$88.40	$88.40	$88.40
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.94 / $56.15 / $68.19	Professional		$41.94	$56.15	$68.19
United Facility/Professional Professional Modifier Low / Median / High Price $42.59 / $60.11 / $132.41	Professional		$42.59	$60.11	$132.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $15.88 / $36.95	Professional	26	$6.64	$15.88	$36.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.71 / $41.98 / $98.06	Professional	TC	$26.71	$41.98	$98.06