Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.92 / $9.25 / $59.56	Facility	26	$8.92	$9.25	$59.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.76 / $31.13 / $156.00	Professional		$25.76	$31.13	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.48 / $9.31 / $25.25	Professional	26	$8.48	$9.31	$25.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.28 / $20.55 / $52.40	Professional	TC	$17.28	$20.55	$52.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.93 / $23.93 / $23.93	Professional		$23.93	$23.93	$23.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $7.09 / $7.09	Professional	26	$7.09	$7.09	$7.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $41.37 / $102.13	Professional		$30.40	$41.37	$102.13
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $14.02 / $28.42	Professional	26	$11.07	$14.02	$28.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $18.60 / $26.33 / $73.87	Professional	TC	$18.60	$26.33	$73.87
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $34.67 / $85.47	Professional		$27.16	$34.67	$85.47
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.74 / $28.03	Professional	26	$9.55	$12.74	$28.03
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $21.86 / $57.33	Professional	TC	$17.44	$21.86	$57.33
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 Professional Modifier Low / Median / High Price $26.22 / $41.23 / $84.27	Professional		$26.22	$41.23	$84.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $12.93 / $28.14	Professional	26	$8.92	$12.93	$28.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $28.91 / $61.95	Professional	TC	$18.00	$28.91	$61.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $41.29 / $55.74	Professional		$25.10	$41.29	$55.74
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.28 / $10.40 / $14.04	Professional	26	$9.28	$10.40	$14.04
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.81 / $30.90 / $41.72	Professional	TC	$15.81	$30.90	$41.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.25 / $41.14 / $72.45	Professional		$31.25	$41.14	$72.45
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 $24.72 / $35.81 / $58.03	Professional	TC	$24.72	$35.81	$58.03
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.54 / $70.00 / $80.00	Facility	26	$24.54	$70.00	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $197.88 / $197.88 / $269.02	Professional		$197.88	$197.88	$269.02
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $232.03 / $232.03 / $232.03	Professional	26	$232.03	$232.03	$232.03
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $142.29 / $146.19 / $193.58	Professional	TC	$142.29	$146.19	$193.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.01 / $32.34 / $32.34	Professional		$20.01	$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 Professional Modifier Low / Median / High Price $27.56 / $46.54 / $84.27	Professional		$27.56	$46.54	$84.27
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.97 / $12.54 / $27.26	Professional	26	$8.97	$12.54	$27.26
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $28.76 / $59.10	Professional	TC	$18.00	$28.76	$59.10
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $107.28 / $107.28 / $107.28	Professional		$107.28	$107.28	$107.28
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $33.29 / $33.29	Professional	26	$33.29	$33.29	$33.29
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $73.97 / $73.97 / $73.97	Professional	TC	$73.97	$73.97	$73.97
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $37.57 / $45.91	Professional		$32.63	$37.57	$45.91
United Facility/Professional Professional Modifier Low / Median / High Price $21.12 / $34.08 / $85.78	Professional		$21.12	$34.08	$85.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $11.01 / $29.95	Professional	26	$7.64	$11.01	$29.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.17 / $22.37 / $57.57	Professional	TC	$13.17	$22.37	$57.57