Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $56.23 / $158.49	Professional		$25.70	$56.23	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $10.47 / $45.71	Professional	26	$5.01	$10.47	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $48.98 / $100.00	Professional	TC	$19.05	$48.98	$100.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $60.26	Professional		$16.22	$16.22	$60.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.31 / $7.41 / $33.11	Professional	26	$3.31	$7.41	$33.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $54.95 / $125.89	Professional		$23.44	$54.95	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $13.18 / $26.92	Professional	26	$6.61	$13.18	$26.92
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $45.71 / $107.15	Professional	TC	$13.49	$45.71	$107.15
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $120.23	Professional		$40.74	$54.95	$120.23
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $18.20 / $38.02	Professional	26	$5.89	$18.20	$38.02
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $42.66 / $100.00	Professional	TC	$26.92	$42.66	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $29.51 / $89.13	Professional		$16.60	$29.51	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.39 / $4.27 / $12.88	Professional	26	$3.39	$4.27	$12.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $25.70 / $69.18	Professional	TC	$12.59	$25.70	$69.18
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $43.65 / $58.88	Professional		$20.89	$43.65	$58.88
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.47 / $16.60	Professional	26	$7.76	$10.47	$16.60
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.17 / $36.31 / $48.98	Professional	TC	$4.17	$36.31	$48.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $40.74 / $66.07	Professional		$33.88	$40.74	$66.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.91 / $11.48	Professional	26	$6.17	$8.91	$11.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $53.70	Professional	TC	$26.92	$39.81	$53.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $281.84 / $281.84	Professional		$269.15	$281.84	$281.84
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	26	$144.54	$144.54	$144.54
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $234.42	Professional	TC	$229.09	$229.09	$234.42
Providence Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $52.48 / $89.13	Facility		$25.70	$52.48	$89.13
Providence Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $34.67 / $95.50	Professional		$16.98	$34.67	$95.50
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.47 / $5.13 / $19.95	Professional	26	$3.47	$5.13	$19.95
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $26.30 / $74.13	Professional	TC	$12.59	$26.30	$74.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Professional	26	$25.70	$25.70	$25.70
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $91.20 / $91.20	Professional	TC	$91.20	$91.20	$91.20
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $48.98	Professional		$36.31	$36.31	$48.98
United Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Facility		$60.26	$60.26	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $89.13	Professional		$19.05	$29.51	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $4.57 / $17.38	Professional	26	$3.89	$4.57	$17.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $25.70 / $72.44	Professional	TC	$14.45	$25.70	$72.44