Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.55 / $21.54 / $127.44	Facility	26	$19.55	$21.54	$127.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.16 / $43.86 / $92.90	Professional		$29.16	$43.86	$92.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $21.77 / $50.28	Professional	26	$18.70	$21.77	$50.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.60 / $12.36 / $54.79	Professional	TC	$9.60	$12.36	$54.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.78 / $46.12 / $102.00	Professional		$45.78	$46.12	$102.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.77 / $108.11	Professional		$31.62	$44.77	$108.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.09 / $27.64 / $55.50	Professional	26	$21.09	$27.64	$55.50
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $10.14 / $14.91 / $59.95	Professional	TC	$10.14	$14.91	$59.95
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $21.48 / $30.43 / $82.87	Professional		$21.48	$30.43	$82.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $19.57 / $48.95	Professional	26	$13.71	$19.57	$48.95
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $7.54 / $10.75 / $28.51	Professional	TC	$7.54	$10.75	$28.51
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $23.51 / $23.51	Facility	26	$23.51	$23.51	$23.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $55.92 / $154.49	Professional		$32.52	$55.92	$154.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $28.55 / $71.70	Professional	26	$21.67	$28.55	$71.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.82 / $25.82 / $88.36	Professional	TC	$10.82	$25.82	$88.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $66.05 / $89.17	Professional		$27.40	$66.05	$89.17
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $22.76 / $30.73	Professional	26	$17.80	$22.76	$30.73
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.59 / $43.29 / $58.44	Professional	TC	$9.59	$43.29	$58.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $60.66 / $110.11	Professional		$48.47	$60.66	$110.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.66 / $22.76 / $49.62	Professional	26	$18.66	$22.76	$49.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.80 / $43.29 / $94.37	Professional	TC	$31.80	$43.29	$94.37
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.04 / $80.00 / $100.32	Facility	26	$48.04	$80.00	$100.32
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $355.02 / $355.02 / $434.33	Professional		$355.02	$355.02	$434.33
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $132.09 / $164.40	Professional	26	$132.09	$132.09	$164.40
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $222.93 / $222.93 / $269.93	Professional	TC	$222.93	$222.93	$269.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.41 / $32.34 / $73.23	Professional		$29.41	$32.34	$73.23
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $23.51 / $23.51 / $23.51	Facility	26	$23.51	$23.51	$23.51
Providence Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $65.20 / $138.65	Professional		$34.03	$65.20	$138.65
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $21.67 / $27.78 / $59.02	Professional	26	$21.67	$27.78	$59.02
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $10.82 / $22.56 / $67.08	Professional	TC	$10.82	$22.56	$67.08
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $157.26 / $157.26 / $157.26	Professional		$157.26	$157.26	$157.26
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $71.26 / $71.26 / $71.26	Professional	26	$71.26	$71.26	$71.26
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $85.99 / $85.99 / $85.99	Professional	TC	$85.99	$85.99	$85.99
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.61 / $49.31 / $73.45	Professional		$35.61	$49.31	$73.45
United Facility/Professional Professional Modifier Low / Median / High Price $28.86 / $44.22 / $115.00	Professional		$28.86	$44.22	$115.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $22.38 / $50.90	Professional	26	$16.80	$22.38	$50.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.05 / $22.32 / $60.38	Professional	TC	$9.05	$22.32	$60.38