Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.01 / $9.86 / $57.07	Facility	26	$9.01	$9.86	$57.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $73.36 / $327.00	Professional		$24.59	$73.36	$327.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.83 / $10.39 / $54.00	Professional	26	$8.83	$10.39	$54.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.71 / $63.97 / $119.70	Professional	TC	$15.71	$63.97	$119.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.70 / $21.20 / $55.99	Professional		$17.70	$21.20	$55.99
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $9.01 / $22.42	Professional	26	$6.94	$9.01	$22.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $11.27 / $11.27 / $11.27	Professional	TC	$11.27	$11.27	$11.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $91.21 / $210.46	Professional		$33.72	$91.21	$210.46
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.30 / $27.31	Professional	26	$9.77	$13.30	$27.31
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.89 / $76.47 / $191.64	Professional	TC	$19.89	$76.47	$191.64
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $44.61 / $100.00	Professional		$31.92	$44.61	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.19 / $5.71 / $16.48	Professional	26	$4.19	$5.71	$16.48
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $27.35 / $38.88 / $94.09	Professional	TC	$27.35	$38.88	$94.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $48.21 / $160.49	Professional		$20.46	$48.21	$160.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $12.25 / $26.14	Professional	26	$8.28	$12.25	$26.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.17 / $35.19 / $152.38	Professional	TC	$12.17	$35.19	$152.38
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.57 / $35.83 / $43.97	Professional		$32.57	$35.83	$43.97
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.40 / $11.44 / $14.04	Professional	26	$10.40	$11.44	$14.04
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.18 / $24.40 / $29.94	Professional	TC	$22.18	$24.40	$29.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $32.32 / $61.23	Professional		$24.86	$32.32	$61.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.22 / $12.48 / $19.55	Professional	26	$9.22	$12.48	$19.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $25.56 / $41.70	Professional	TC	$17.14	$25.56	$41.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $51.68 / $100.00 / $132.00	Facility	26	$51.68	$100.00	$132.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $10.19 / $53.18 / $53.18	Facility	53	$10.19	$53.18	$53.18
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $556.59 / $761.56 / $761.56	Professional		$556.59	$761.56	$761.56
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.00 / $132.00 / $132.00	Professional	26	$132.00	$132.00	$132.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $525.26 / $705.08 / $705.08	Professional	TC	$525.26	$705.08	$705.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.06 / $32.34 / $32.34	Professional		$14.06	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Providence Facility/Professional Professional Modifier Low / Median / High Price $21.10 / $50.41 / $152.91	Professional		$21.10	$50.41	$152.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $12.10 / $26.03	Professional	26	$8.28	$12.10	$26.03
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $38.65 / $164.11	Professional	TC	$12.33	$38.65	$164.11
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $76.02 / $76.02 / $76.02	Professional		$76.02	$76.02	$76.02
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $32.10 / $32.10 / $32.10	Professional	26	$32.10	$32.10	$32.10
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $43.92 / $43.92 / $43.92	Professional	TC	$43.92	$43.92	$43.92
United Facility/Professional Professional Modifier Low / Median / High Price $19.94 / $35.19 / $108.01	Professional		$19.94	$35.19	$108.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.11 / $23.75	Professional	26	$8.02	$10.11	$23.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.35 / $20.86 / $83.99	Professional	TC	$11.35	$20.86	$83.99