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 / $91.63	Facility	26	$7.48	$7.84	$91.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.14 / $35.76 / $111.00	Professional		$17.14	$35.76	$111.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.32 / $15.46 / $54.00	Professional	26	$7.32	$15.46	$54.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.11 / $16.53 / $48.42	Professional	TC	$10.11	$16.53	$48.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.89 / $33.89 / $33.89	Professional		$33.89	$33.89	$33.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $22.00 / $30.45	Professional	26	$12.43	$22.00	$30.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.47 / $28.35 / $64.33	Professional		$19.47	$28.35	$64.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $11.09 / $23.14	Professional	26	$8.60	$11.09	$23.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.93 / $17.46 / $40.96	Professional	TC	$10.93	$17.46	$40.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $16.63 / $20.46 / $60.99	Professional		$16.63	$20.46	$60.99
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $9.40 / $25.79	Professional	26	$7.98	$9.40	$25.79
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $8.65 / $10.95 / $35.90	Professional	TC	$8.65	$10.95	$35.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.30 / $32.65 / $87.33	Professional		$19.30	$32.65	$87.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.70 / $12.15 / $31.87	Professional	26	$7.70	$12.15	$31.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.90 / $20.66 / $56.71	Professional	TC	$10.90	$20.66	$56.71
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $14.48 / $54.95 / $74.18	Professional		$14.48	$54.95	$74.18
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $16.71 / $22.56	Professional	26	$6.81	$16.71	$22.56
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.67 / $38.24 / $51.62	Professional	TC	$7.67	$38.24	$51.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.64 / $54.58 / $86.39	Professional		$40.64	$54.58	$86.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.77 / $20.05 / $31.41	Professional	26	$14.77	$20.05	$31.41
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 $738.38 / $753.15 / $753.15	Professional		$738.38	$753.15	$753.15
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.54 / $95.54 / $122.10	Professional	26	$95.54	$95.54	$122.10
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $724.28 / $738.76 / $738.76	Professional	TC	$724.28	$738.76	$738.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $32.34 / $32.34	Professional		$24.85	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $20.61 / $39.54 / $108.72	Professional		$20.61	$39.54	$108.72
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.98 / $11.93 / $30.62	Professional	26	$7.98	$11.93	$30.62
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $11.13 / $20.42 / $53.21	Professional	TC	$11.13	$20.42	$53.21
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $142.22 / $142.22 / $142.22	Professional		$142.22	$142.22	$142.22
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $51.43 / $51.43 / $51.43	Professional	26	$51.43	$51.43	$51.43
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $90.80 / $90.80	Professional	TC	$90.80	$90.80	$90.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $21.72 / $56.00 / $68.00	Professional		$21.72	$56.00	$68.00
United Facility/Professional Professional Modifier Low / Median / High Price $16.82 / $43.67 / $101.96	Professional		$16.82	$43.67	$101.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $16.23 / $36.51	Professional	26	$6.36	$16.23	$36.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $27.43 / $68.13	Professional	TC	$10.23	$27.43	$68.13