Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $14.13 / $40.74	Facility	26	$7.08	$14.13	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $37.15 / $117.49	Professional		$17.38	$37.15	$117.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $17.38 / $56.23	Professional	26	$7.41	$17.38	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $20.89 / $54.95	Professional	TC	$10.00	$20.89	$54.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $251.19	Professional		$57.54	$83.18	$251.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $26.92 / $34.67	Professional	26	$14.45	$26.92	$34.67
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $33.11 / $74.13	Professional		$20.89	$33.11	$74.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $28.18	Professional	26	$8.71	$12.30	$28.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $21.38 / $47.86	Professional	TC	$12.02	$21.38	$47.86
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $26.30 / $64.57	Professional		$18.62	$26.30	$64.57
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $25.70	Professional	26	$8.91	$12.02	$25.70
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $14.45 / $38.02	Professional	TC	$9.55	$14.45	$38.02
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 $18.20 / $33.11 / $81.28	Professional		$18.20	$33.11	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $12.30 / $31.62	Professional	26	$7.76	$12.30	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $19.95 / $54.95	Professional	TC	$10.47	$19.95	$54.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $56.23 / $75.86	Professional		$14.45	$56.23	$75.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $16.98 / $22.91	Professional	26	$6.76	$16.98	$22.91
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.59 / $39.81 / $53.70	Professional	TC	$7.59	$39.81	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $53.70 / $87.10	Professional		$41.69	$53.70	$87.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $31.62	Professional	26	$14.79	$19.50	$31.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $42.66 / $74.13	Professional	TC	$33.11	$42.66	$74.13
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 $758.58 / $758.58 / $758.58	Professional		$758.58	$758.58	$758.58
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $123.03 / $123.03	Professional	26	$95.50	$123.03	$123.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $741.31 / $741.31	Professional	TC	$741.31	$741.31	$741.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $32.36 / $47.86	Professional		$17.78	$32.36	$47.86
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 $19.50 / $35.48 / $93.33	Professional		$19.50	$35.48	$93.33
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.22 / $27.54	Professional	26	$7.94	$11.22	$27.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $19.95 / $53.70	Professional	TC	$10.96	$19.95	$53.70
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $51.29 / $51.29	Professional	26	$51.29	$51.29	$51.29
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $52.48 / $67.61	Professional		$21.88	$52.48	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $41.69 / $85.11	Professional		$15.85	$41.69	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $15.49 / $30.90	Professional	26	$6.31	$15.49	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.23 / $26.92 / $54.95	Professional	TC	$10.23	$26.92	$54.95