Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.07 / $15.63 / $100.50	Facility	26	$15.07	$15.63	$100.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $45.87 / $163.40	Professional		$37.59	$45.87	$163.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $16.57 / $81.54	Professional	26	$13.42	$16.57	$81.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $29.29 / $56.30	Professional	TC	$23.51	$29.29	$56.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $49.54 / $76.20	Professional		$36.01	$49.54	$76.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $12.07 / $28.40 / $68.00	Professional	26	$12.07	$28.40	$68.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.63 / $59.66 / $122.71	Professional		$42.63	$59.66	$122.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $20.86 / $40.36	Professional	26	$16.75	$20.86	$40.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.64 / $36.27 / $81.84	Professional	TC	$26.64	$36.27	$81.84
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $46.52 / $109.49	Professional		$36.44	$46.52	$109.49
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $14.85 / $18.87 / $44.89	Professional	26	$14.85	$18.87	$44.89
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $26.97 / $73.86	Professional	TC	$21.48	$26.97	$73.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $58.18 / $122.30	Professional		$36.61	$58.18	$122.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.03 / $19.97 / $43.67	Professional	26	$14.03	$19.97	$43.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.54 / $84.72	Professional	TC	$23.99	$38.54	$84.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $59.32 / $80.08	Professional		$33.22	$59.32	$80.08
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $18.32 / $24.75	Professional	26	$13.96	$18.32	$24.75
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.27 / $40.99 / $55.34	Professional	TC	$19.27	$40.99	$55.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.09 / $59.31 / $100.20	Professional		$45.09	$59.31	$100.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $22.00 / $34.46	Professional	26	$16.14	$22.00	$34.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $47.48 / $76.95	Professional	TC	$32.79	$47.48	$76.95
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $61.10 / $80.66 / $80.66	Facility	26	$61.10	$80.66	$80.66
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $301.08 / $301.08 / $388.65	Professional		$301.08	$301.08	$388.65
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.20 / $104.20 / $132.90	Professional	26	$104.20	$104.20	$132.90
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $196.89 / $196.89 / $255.75	Professional	TC	$196.89	$196.89	$255.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.21 / $32.34 / $32.34	Professional		$28.21	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $64.50 / $125.79	Professional		$39.36	$64.50	$125.79
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.42 / $19.38 / $43.04	Professional	26	$14.42	$19.38	$43.04
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $38.54 / $80.90	Professional	TC	$24.16	$38.54	$80.90
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $151.75 / $151.75 / $151.75	Professional		$151.75	$151.75	$151.75
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $56.13 / $56.13 / $56.13	Professional	26	$56.13	$56.13	$56.13
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $95.61 / $95.61 / $95.61	Professional	TC	$95.61	$95.61	$95.61
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $43.20 / $53.96 / $65.95	Professional		$43.20	$53.96	$65.95
United Facility/Professional Professional Modifier Low / Median / High Price $36.38 / $48.51 / $114.53	Professional		$36.38	$48.51	$114.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $17.68 / $49.52	Professional	26	$12.73	$17.68	$49.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $30.77 / $74.37	Professional	TC	$23.65	$30.77	$74.37