Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $18.44 / $106.07	Facility	26	$16.60	$18.44	$106.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.26 / $116.64 / $491.66	Professional		$96.26	$116.64	$491.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.23 / $96.00	Professional	26	$16.60	$23.23	$96.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.73 / $98.85 / $186.46	Professional	TC	$78.73	$98.85	$186.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.95 / $73.51 / $522.78	Professional		$60.95	$73.51	$522.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $26.72 / $39.57	Professional	26	$14.60	$26.72	$39.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.26 / $121.29 / $244.38	Professional		$85.26	$121.29	$244.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.87 / $24.79 / $50.18	Professional	26	$16.87	$24.79	$50.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.45 / $96.16 / $200.43	Professional	TC	$63.45	$96.16	$200.43
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $93.27 / $118.53 / $274.39	Professional		$93.27	$118.53	$274.39
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.78 / $20.11 / $50.55	Professional	26	$14.78	$20.11	$50.55
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $76.55 / $100.00 / $226.70	Professional	TC	$76.55	$100.00	$226.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.79 / $124.49 / $281.36	Professional		$75.79	$124.49	$281.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.57 / $22.59 / $50.16	Professional	26	$15.57	$22.59	$50.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.14 / $102.74 / $238.67	Professional	TC	$60.14	$102.74	$238.67
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $127.92 / $172.69	Professional		$63.56	$127.92	$172.69
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $19.46 / $26.27	Professional	26	$13.35	$19.46	$26.27
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.21 / $108.47 / $146.43	Professional	TC	$50.21	$108.47	$146.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $126.31 / $209.55	Professional		$98.74	$126.31	$209.55
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.43 / $23.56 / $41.22	Professional	26	$17.43	$23.56	$41.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.43 / $127.10 / $203.92	Professional	TC	$88.43	$127.10	$203.92
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $67.16 / $87.12 / $87.12	Facility	26	$67.16	$87.12	$87.12
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $664.33 / $664.33 / $819.75	Professional		$664.33	$664.33	$819.75
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $113.72 / $113.72 / $148.19	Professional	26	$113.72	$113.72	$148.19
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $550.61 / $550.61 / $671.63	Professional	TC	$550.61	$550.61	$671.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $76.20	Professional		$32.34	$32.34	$76.20
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $80.84 / $135.65 / $276.74	Professional		$80.84	$135.65	$276.74
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $22.13 / $49.32	Professional	26	$15.77	$22.13	$49.32
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $102.00 / $231.77	Professional	TC	$63.61	$102.00	$231.77
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $321.64 / $321.64 / $321.64	Professional		$321.64	$321.64	$321.64
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $60.14 / $60.14 / $60.14	Professional	26	$60.14	$60.14	$60.14
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $261.51 / $261.51 / $261.51	Professional	TC	$261.51	$261.51	$261.51
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.56 / $108.06 / $142.24	Professional		$63.56	$108.06	$142.24
United Facility/Professional Professional Modifier Low / Median / High Price $71.64 / $104.91 / $247.81	Professional		$71.64	$104.91	$247.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $19.34 / $46.81	Professional	26	$14.93	$19.34	$46.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $83.18 / $203.27	Professional	TC	$58.26	$83.18	$203.27