Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $454.56 / $1,177.48 / $1,491.06	Professional		$454.56	$1,177.48	$1,491.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.77 / $201.47 / $255.12	Professional	26	$77.77	$201.47	$255.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $376.79 / $976.02 / $1,235.94	Professional	TC	$376.79	$976.02	$1,235.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $318.00 / $439.00 / $823.05	Professional		$318.00	$439.00	$823.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $141.00 / $160.00 / $160.00	Professional	26	$141.00	$160.00	$160.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $217.00 / $658.70 / $658.70	Professional	TC	$217.00	$658.70	$658.70
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $120.13 / $205.41 / $205.41	Facility	26	$120.13	$205.41	$205.41
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,782.62 / $1,782.62 / $1,782.62	Professional		$1,782.62	$1,782.62	$1,782.62
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $313.70 / $313.70 / $313.70	Professional	26	$313.70	$313.70	$313.70
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,468.91 / $1,468.91 / $1,468.91	Professional	TC	$1,468.91	$1,468.91	$1,468.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $351.86 / $549.12 / $783.75	Professional		$351.86	$549.12	$783.75
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $66.59 / $66.59 / $66.59	Professional	26	$66.59	$66.59	$66.59
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $302.43 / $302.43 / $307.13	Professional	TC	$302.43	$302.43	$307.13
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $931.17 / $931.17 / $931.17	Professional		$931.17	$931.17	$931.17
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $168.92 / $168.92 / $168.92	Professional	26	$168.92	$168.92	$168.92
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $762.25 / $762.25 / $762.25	Professional	TC	$762.25	$762.25	$762.25