Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.34 / $8.07 / $42.38	Facility	26	$7.34	$8.07	$42.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.68 / $44.01 / $147.00	Professional		$27.68	$44.01	$147.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.29 / $12.72 / $38.89	Professional	26	$7.29	$12.72	$38.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $23.57 / $62.74	Professional	TC	$19.03	$23.57	$62.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.37 / $50.64 / $131.90	Professional		$18.37	$50.64	$131.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.49 / $11.50 / $19.11	Professional	26	$6.49	$11.50	$19.11
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.57 / $37.57 / $37.57	Professional	TC	$37.57	$37.57	$37.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.90 / $62.48 / $111.30	Professional		$31.90	$62.48	$111.30
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.81 / $15.24 / $26.82	Professional	26	$8.81	$15.24	$26.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $45.93 / $85.96	Professional	TC	$23.38	$45.93	$85.96
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $29.12 / $38.64 / $100.00	Professional		$29.12	$38.64	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $9.44 / $25.08	Professional	26	$7.50	$9.44	$25.08
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $29.14 / $74.17	Professional	TC	$21.63	$29.14	$74.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $8.11	Facility	26	$8.11	$8.11	$8.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.50 / $45.00 / $89.00	Professional		$28.50	$45.00	$89.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.64 / $10.34 / $21.78	Professional	26	$7.64	$10.34	$21.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.74 / $35.61 / $74.43	Professional	TC	$21.74	$35.61	$74.43
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $38.94 / $58.41	Professional		$32.04	$38.94	$58.41
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.72 / $15.58 / $23.37	Professional	26	$7.72	$15.58	$23.37
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.36 / $26.76 / $35.04	Professional	TC	$23.36	$26.76	$35.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $23.53 / $32.06 / $70.18	Professional		$23.53	$32.06	$70.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.87 / $9.65 / $16.82	Professional	26	$6.87	$9.65	$16.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $28.51 / $47.68	Professional	TC	$19.82	$28.51	$47.68
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.32 / $100.00 / $103.69	Facility	26	$19.32	$100.00	$103.69
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $644.00 / $644.00	Professional		$644.00	$644.00	$644.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $148.60 / $228.88 / $228.88	Professional	26	$148.60	$228.88	$228.88
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $542.00 / $542.00 / $542.00	Professional	TC	$542.00	$542.00	$542.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.08 / $32.34 / $32.34	Professional		$24.08	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $8.11 / $8.11 / $8.11	Facility	26	$8.11	$8.11	$8.11
Providence Facility/Professional Professional Modifier Low / Median / High Price $29.35 / $48.57 / $80.28	Professional		$29.35	$48.57	$80.28
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $10.03 / $19.80	Professional	26	$7.68	$10.03	$19.80
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $21.92 / $36.61 / $69.22	Professional	TC	$21.92	$36.61	$69.22
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $88.85 / $88.85	Professional		$88.85	$88.85	$88.85
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $23.93 / $23.93 / $23.93	Professional	26	$23.93	$23.93	$23.93
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $64.91 / $64.91 / $64.91	Professional	TC	$64.91	$64.91	$64.91
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $25.92 / $38.94 / $106.27	Professional		$25.92	$38.94	$106.27
United Facility/Professional Professional Modifier Low / Median / High Price $21.00 / $34.17 / $81.86	Professional		$21.00	$34.17	$81.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.94 / $8.61 / $19.77	Professional	26	$5.94	$8.61	$19.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $24.84 / $57.99	Professional	TC	$15.59	$24.84	$57.99