Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $38.02 / $114.82	Facility	26	$19.05	$38.02	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $128.82	Professional		$29.51	$51.29	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $22.39 / $66.07	Professional	26	$19.05	$22.39	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $26.92 / $63.10	Professional	TC	$10.00	$26.92	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $75.86 / $125.89	Professional		$47.86	$75.86	$125.89
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $47.86	Professional	26	$19.50	$19.50	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $125.89	Professional		$33.88	$50.12	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.62 / $60.26	Professional	26	$21.88	$31.62	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $16.98 / $70.79	Professional	TC	$10.96	$16.98	$70.79
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $91.20	Professional		$25.70	$35.48	$91.20
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $23.44 / $52.48	Professional	26	$17.38	$23.44	$52.48
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $12.30 / $34.67	Professional	TC	$9.12	$12.30	$34.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $23.44 / $33.11	Facility	26	$5.01	$23.44	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $54.95 / $144.54	Professional		$33.88	$54.95	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $61.66	Professional	26	$21.88	$28.18	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $25.70 / $83.18	Professional	TC	$10.96	$25.70	$83.18
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $69.18 / $93.33	Professional		$27.54	$69.18	$93.33
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $23.99 / $32.36	Professional	26	$17.78	$23.99	$32.36
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $44.67 / $60.26	Professional	TC	$9.55	$44.67	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $61.66 / $104.71	Professional		$50.12	$61.66	$104.71
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $21.88 / $38.90	Professional	26	$19.50	$21.88	$38.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $40.74 / $69.18	Professional	TC	$33.11	$40.74	$69.18
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $436.52 / $436.52	Professional		$354.81	$436.52	$436.52
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $165.96 / $165.96	Professional	26	$131.83	$165.96	$165.96
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $269.15 / $269.15	Professional	TC	$223.87	$269.15	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $72.44	Professional		$29.51	$43.65	$72.44
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $57.54 / $134.90	Professional		$33.88	$57.54	$134.90
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $57.54	Professional	26	$21.88	$28.18	$57.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $22.39 / $67.61	Professional	TC	$10.96	$22.39	$67.61
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	26	$70.79	$70.79	$70.79
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	TC	$85.11	$85.11	$85.11
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $46.77 / $63.10	Professional		$27.54	$46.77	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $107.15	Professional		$28.84	$43.65	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.91 / $48.98	Professional	26	$16.98	$22.91	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $21.38 / $57.54	Professional	TC	$9.12	$21.38	$57.54