Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.92 / $28.82 / $154.88	Facility	26	$25.92	$28.82	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $60.59 / $198.00	Professional		$42.46	$60.59	$198.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $28.87 / $107.66	Professional	26	$24.48	$28.87	$107.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.67 / $22.34 / $58.84	Professional	TC	$16.67	$22.34	$58.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $54.79 / $54.79	Professional		$54.79	$54.79	$54.79
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.49 / $50.49 / $50.49	Professional	26	$50.49	$50.49	$50.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.42 / $63.90 / $142.88	Professional		$45.42	$63.90	$142.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $37.21 / $74.15	Professional	26	$28.10	$37.21	$74.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.19 / $25.11 / $67.70	Professional	TC	$17.19	$25.11	$67.70
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $33.28 / $47.25 / $104.85	Professional		$33.28	$47.25	$104.85
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $19.51 / $27.87 / $69.38	Professional	26	$19.51	$27.87	$69.38
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $13.62 / $19.14 / $49.76	Professional	TC	$13.62	$19.14	$49.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.51 / $28.51 / $28.51	Facility	26	$28.51	$28.51	$28.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.78 / $70.84 / $185.43	Professional		$46.78	$70.84	$185.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $37.00 / $88.43	Professional	26	$27.59	$37.00	$88.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $34.14 / $102.48	Professional	TC	$18.68	$34.14	$102.48
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.23 / $74.27 / $100.26	Professional		$42.23	$74.27	$100.26
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.34 / $30.41 / $37.49	Professional	26	$25.34	$30.41	$37.49
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.89 / $46.50 / $62.78	Professional	TC	$16.89	$46.50	$62.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.63 / $68.33 / $133.54	Professional		$54.63	$68.33	$133.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $27.77 / $60.54	Professional	26	$22.71	$27.77	$60.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.15 / $46.50 / $101.37	Professional	TC	$34.15	$46.50	$101.37
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $58.37 / $97.18 / $122.08	Facility	26	$58.37	$97.18	$122.08
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $398.18 / $398.18 / $488.70	Professional		$398.18	$398.18	$488.70
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $160.04 / $160.04 / $198.98	Professional	26	$160.04	$160.04	$198.98
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $238.14 / $238.14 / $289.73	Professional	TC	$238.14	$238.14	$289.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $35.61 / $82.57	Professional		$32.34	$35.61	$82.57
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $28.51 / $28.51 / $28.51	Facility	26	$28.51	$28.51	$28.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $49.36 / $77.31 / $164.38	Professional		$49.36	$77.31	$164.38
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $35.72 / $71.58	Professional	26	$27.59	$35.72	$71.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $31.48 / $75.91	Professional	TC	$18.68	$31.48	$75.91
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $178.45 / $178.45 / $178.45	Professional		$178.45	$178.45	$178.45
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $86.44 / $86.44 / $86.44	Professional	26	$86.44	$86.44	$86.44
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $92.01 / $92.01 / $92.01	Professional	TC	$92.01	$92.01	$92.01
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $63.35 / $82.58	Professional		$54.90	$63.35	$82.58
United Facility/Professional Professional Modifier Low / Median / High Price $38.25 / $53.20 / $133.94	Professional		$38.25	$53.20	$133.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.52 / $29.13 / $67.51	Professional	26	$20.52	$29.13	$67.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.40 / $25.38 / $68.78	Professional	TC	$15.40	$25.38	$68.78