Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.61 / $23.85 / $146.06	Facility	26	$22.61	$23.85	$146.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $85.64 / $292.70	Professional		$41.75	$85.64	$292.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $40.00 / $134.00	Professional	26	$21.37	$40.00	$134.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.43 / $23.21 / $89.12	Professional	TC	$19.43	$23.21	$89.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.97 / $43.38 / $105.56	Professional		$40.97	$43.38	$105.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.67 / $53.39 / $107.00	Professional	26	$18.67	$53.39	$107.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $72.04 / $171.36	Professional		$46.42	$72.04	$171.36
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $35.44 / $70.06	Professional	26	$23.50	$35.44	$70.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.90 / $35.58 / $110.48	Professional	TC	$22.90	$35.58	$110.48
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $42.32 / $54.75 / $131.75	Professional		$42.32	$54.75	$131.75
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $21.26 / $26.70 / $74.00	Professional	26	$21.26	$26.70	$74.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $28.51 / $78.44	Professional	TC	$21.06	$28.51	$78.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.94 / $70.62 / $143.11	Professional		$40.94	$70.62	$143.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.84 / $31.71 / $69.48	Professional	26	$21.84	$31.71	$69.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $37.85 / $93.15	Professional	TC	$20.19	$37.85	$93.15
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $54.60 / $73.70	Professional		$38.72	$54.60	$73.70
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.14 / $26.46 / $35.72	Professional	26	$20.14	$26.46	$35.72
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $28.14 / $37.99	Professional	TC	$18.59	$28.14	$37.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $56.58 / $106.04	Professional		$43.29	$56.58	$106.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.30 / $32.89 / $55.34	Professional	26	$23.30	$32.89	$55.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $33.06 / $55.29	Professional	TC	$22.51	$33.06	$55.29
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $55.98 / $105.96 / $115.95	Facility	26	$55.98	$105.96	$115.95
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $426.95 / $495.56 / $495.56	Professional		$426.95	$495.56	$495.56
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $151.44 / $151.44 / $186.98	Professional	26	$151.44	$151.44	$186.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.63 / $378.66 / $378.66	Professional	TC	$367.63	$378.66	$378.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $73.86	Professional		$32.34	$32.34	$73.86
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Providence Facility/Professional Professional Modifier Low / Median / High Price $42.51 / $80.79 / $134.78	Professional		$42.51	$80.79	$134.78
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.98 / $30.73 / $68.86	Professional	26	$21.98	$30.73	$68.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $20.19 / $38.69 / $93.15	Professional	TC	$20.19	$38.69	$93.15
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $154.50 / $154.50 / $154.50	Professional		$154.50	$154.50	$154.50
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $81.73 / $81.73 / $81.73	Professional	26	$81.73	$81.73	$81.73
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $72.77 / $72.77 / $72.77	Professional	TC	$72.77	$72.77	$72.77
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $54.23 / $65.84	Professional		$44.16	$54.23	$65.84
United Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $50.30 / $141.13	Professional		$36.50	$50.30	$141.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.19 / $25.62 / $66.87	Professional	26	$18.19	$25.62	$66.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.70 / $25.61 / $67.66	Professional	TC	$17.70	$25.61	$67.66