Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.75 / $15.13 / $91.43	Facility	26	$13.75	$15.13	$91.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $32.36 / $74.65	Professional		$25.37	$32.36	$74.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $15.38 / $36.86	Professional	26	$13.49	$15.38	$36.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.63 / $15.59 / $51.90	Professional	TC	$11.63	$15.59	$51.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.28 / $38.13 / $93.67	Professional		$27.28	$38.13	$93.67
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.60 / $19.12 / $38.83	Professional	26	$14.60	$19.12	$38.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $12.39 / $17.93 / $59.74	Professional	TC	$12.39	$17.93	$59.74
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $18.73 / $26.67 / $68.48	Professional		$18.73	$26.67	$68.48
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.73 / $13.89 / $34.74	Professional	26	$9.73	$13.89	$34.74
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $9.02 / $12.67 / $33.59	Professional	TC	$9.02	$12.67	$33.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $16.55 / $16.55	Facility	26	$16.55	$16.55	$16.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.89 / $48.33 / $133.82	Professional		$28.89	$48.33	$133.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.19 / $20.32 / $50.19	Professional	26	$15.19	$20.32	$50.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $27.32 / $90.77	Professional	TC	$13.18	$27.32	$90.77
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $57.20 / $77.22	Professional		$23.84	$57.20	$77.22
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.64 / $16.21 / $21.88	Professional	26	$12.64	$16.21	$21.88
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.20 / $40.99 / $55.34	Professional	TC	$11.20	$40.99	$55.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.52 / $52.22 / $116.00	Professional		$41.52	$52.22	$116.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.23 / $16.21 / $35.34	Professional	26	$13.23	$16.21	$35.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.11 / $40.99 / $89.36	Professional	TC	$30.11	$40.99	$89.36
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.90 / $56.44 / $80.00	Facility	26	$33.90	$56.44	$80.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $306.10 / $306.10 / $371.25	Professional		$306.10	$306.10	$371.25
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $93.99 / $93.99 / $115.50	Professional	26	$93.99	$93.99	$115.50
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $212.11 / $212.11 / $255.75	Professional	TC	$212.11	$212.11	$255.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.66 / $32.34 / $61.82	Professional		$20.66	$32.34	$61.82
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $16.55 / $16.55	Facility	26	$16.55	$16.55	$16.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.32 / $55.50 / $119.91	Professional		$29.32	$55.50	$119.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $19.73 / $41.86	Professional	26	$15.16	$19.73	$41.86
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $24.54 / $65.20	Professional	TC	$13.18	$24.54	$65.20
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $134.41 / $134.41 / $134.41	Professional		$134.41	$134.41	$134.41
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $50.83 / $50.83 / $50.83	Professional	26	$50.83	$50.83	$50.83
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $83.59 / $83.59 / $83.59	Professional	TC	$83.59	$83.59	$83.59
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.99 / $42.91 / $63.61	Professional		$30.99	$42.91	$63.61
United Facility/Professional Professional Modifier Low / Median / High Price $25.08 / $37.61 / $98.99	Professional		$25.08	$37.61	$98.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $16.21 / $37.65	Professional	26	$11.88	$16.21	$37.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.07 / $21.98 / $64.59	Professional	TC	$11.07	$21.98	$64.59