Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.16 / $9.44 / $14.16	Facility	26	$9.16	$9.44	$14.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $10.47 / $30.33	Professional	26	$9.16	$10.47	$30.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.38 / $16.50 / $41.78	Professional	TC	$14.38	$16.50	$41.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.70 / $32.15 / $55.43	Professional	26	$20.70	$32.15	$55.43
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $18.80 / $58.79	Professional	26	$9.74	$18.80	$58.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $15.88 / $27.20 / $90.89	Professional	TC	$15.88	$27.20	$90.89
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $23.61 / $81.20 / $100.00	Professional	26	$23.61	$81.20	$100.00
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $27.69 / $67.53 / $100.00	Professional	TC	$27.69	$67.53	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.15 / $28.15 / $28.15	Facility	26	$28.15	$28.15	$28.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.24 / $33.72 / $72.30	Professional	26	$26.24	$33.72	$72.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.15 / $53.34 / $120.86	Professional	TC	$40.15	$53.34	$120.86
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.55 / $27.31 / $36.86	Professional	26	$21.55	$27.31	$36.86
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.55 / $48.80 / $65.88	Professional	TC	$21.55	$48.80	$65.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.37 / $27.31 / $47.79	Professional	26	$22.37	$27.31	$47.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.84 / $47.08 / $85.40	Professional	TC	$35.84	$47.08	$85.40
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $57.75 / $96.13 / $120.22	Facility	26	$57.75	$96.13	$120.22
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $145.16 / $149.40 / $196.13	Professional	26	$145.16	$149.40	$196.13
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $183.70 / $183.70 / $303.83	Professional	TC	$183.70	$183.70	$303.83
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $28.15 / $28.15 / $28.15	Facility	26	$28.15	$28.15	$28.15
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $33.58 / $68.66	Professional	26	$26.53	$33.58	$68.66
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $40.88 / $52.81 / $110.67	Professional	TC	$40.88	$52.81	$110.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.71 / $27.31 / $112.30	Professional	26	$18.71	$27.31	$112.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.96 / $43.83 / $181.57	Professional	TC	$26.96	$43.83	$181.57