Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.66 / $15.03 / $83.07	Facility	26	$13.66	$15.03	$83.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.66 / $45.25 / $172.30	Professional		$31.66	$45.25	$172.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.77 / $15.46 / $63.40	Professional	26	$10.77	$15.46	$63.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $22.43 / $40.72	Professional	TC	$19.07	$22.43	$40.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.03 / $28.72 / $53.34	Professional		$27.03	$28.72	$53.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.70 / $23.61 / $51.37	Professional	26	$14.70	$23.61	$51.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.54 / $80.20 / $157.61	Professional		$33.54	$80.20	$157.61
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.72 / $30.36 / $59.07	Professional	26	$13.72	$30.36	$59.07
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.37 / $50.52 / $98.69	Professional	TC	$21.37	$50.52	$98.69
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $32.74 / $43.04 / $100.25	Professional		$32.74	$43.04	$100.25
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $14.76 / $30.21	Professional	26	$10.85	$14.76	$30.21
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.83 / $28.43 / $58.94	Professional	TC	$21.83	$28.43	$58.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.45 / $46.73 / $95.24	Professional		$31.45	$46.73	$95.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $17.39 / $35.39	Professional	26	$12.39	$17.39	$35.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $29.99 / $64.22	Professional	TC	$21.46	$29.99	$64.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $38.89 / $52.50	Professional		$32.04	$38.89	$52.50
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $12.50 / $15.75	Professional	26	$11.67	$12.50	$15.75
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.55 / $27.22 / $36.75	Professional	TC	$19.55	$27.22	$36.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.53 / $38.86 / $68.88	Professional		$29.53	$38.86	$68.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.25 / $14.00 / $21.94	Professional	26	$10.25	$14.00	$21.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.78 / $31.56 / $51.15	Professional	TC	$21.78	$31.56	$51.15
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $70.00 / $70.00	Facility	26	$50.00	$70.00	$70.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $195.66 / $195.66 / $254.63	Professional		$195.66	$195.66	$254.63
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $69.84 / $83.70	Professional	26	$69.84	$69.84	$83.70
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.61 / $129.61 / $170.93	Professional	TC	$129.61	$129.61	$170.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.33 / $32.34 / $32.34	Professional		$27.33	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $50.65 / $92.75	Professional		$33.65	$50.65	$92.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $17.57 / $34.72	Professional	26	$12.68	$17.57	$34.72
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.74 / $29.63 / $63.34	Professional	TC	$21.74	$29.63	$63.34
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $123.76 / $123.76 / $123.76	Professional		$123.76	$123.76	$123.76
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $46.17 / $46.17 / $46.17	Professional	26	$46.17	$46.17	$46.17
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $77.58 / $77.58 / $77.58	Professional	TC	$77.58	$77.58	$77.58
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $31.45 / $43.24 / $54.49	Professional		$31.45	$43.24	$54.49
United Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $41.83 / $105.51	Professional		$29.70	$41.83	$105.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $16.41 / $36.47	Professional	26	$11.37	$16.41	$36.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $25.65 / $64.97	Professional	TC	$18.00	$25.65	$64.97