Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.96 / $8.72 / $48.75	Facility	26	$7.96	$8.72	$48.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.50 / $42.42 / $164.22	Professional		$27.50	$42.42	$164.22
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.15 / $37.15 / $47.07	Professional	25	$37.15	$37.15	$47.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.92 / $9.77 / $35.15	Professional	26	$7.92	$9.77	$35.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.77 / $28.34 / $53.45	Professional	TC	$18.77	$28.34	$53.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $27.01 / $60.28	Professional		$23.24	$27.01	$60.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $10.37 / $18.17	Professional	26	$6.98	$10.37	$18.17
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $40.00 / $40.00	Professional	TC	$40.00	$40.00	$40.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.37 / $42.73 / $83.23	Professional		$31.37	$42.73	$83.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $11.28 / $28.27	Professional	26	$8.11	$11.28	$28.27
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $28.95 / $59.79	Professional	TC	$21.63	$28.95	$59.79
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $40.79 / $94.87	Professional		$28.66	$40.79	$94.87
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $7.03 / $10.03 / $23.45	Professional	26	$7.03	$10.03	$23.45
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $21.63 / $30.90 / $71.50	Professional	TC	$21.63	$30.90	$71.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.42 / $45.43 / $94.67	Professional		$32.42	$45.43	$94.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $10.72 / $22.32	Professional	26	$8.36	$10.72	$22.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.02 / $34.51 / $69.83	Professional	TC	$24.02	$34.51	$69.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $24.60 / $35.19 / $46.80	Professional		$24.60	$35.19	$46.80
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $9.84 / $13.28	Professional	26	$8.88	$9.84	$13.28
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.76 / $22.46 / $34.20	Professional	TC	$14.76	$22.46	$34.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $32.53 / $62.55	Professional		$25.75	$32.53	$62.55
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.31 / $10.21 / $18.64	Professional	26	$7.31	$10.21	$18.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.34 / $27.45 / $49.46	Professional	TC	$19.34	$27.45	$49.46
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.87 / $100.00 / $100.00	Facility	26	$18.87	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $400.00 / $400.00	Professional		$67.00	$400.00	$400.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $132.09 / $132.09	Professional	26	$132.09	$132.09	$132.09
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $135.32 / $139.38 / $165.23	Professional	TC	$135.32	$139.38	$165.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $11.60 / $32.34 / $37.60	Professional		$11.60	$32.34	$37.60
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $9.25 / $9.25 / $9.25	Facility	26	$9.25	$9.25	$9.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $47.69 / $81.66	Professional		$33.65	$47.69	$81.66
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $10.55 / $20.96	Professional	26	$8.36	$10.55	$20.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $24.81 / $34.51 / $65.81	Professional	TC	$24.81	$34.51	$65.81
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $118.25 / $118.25 / $118.25	Professional		$118.25	$118.25	$118.25
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $27.44 / $27.44 / $27.44	Professional	26	$27.44	$27.44	$27.44
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $90.80 / $90.80	Professional	TC	$90.80	$90.80	$90.80
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $39.11 / $63.52	Professional		$28.45	$39.11	$63.52
United Facility/Professional Professional Modifier Low / Median / High Price $25.89 / $36.00 / $76.97	Professional		$25.89	$36.00	$76.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.48 / $8.66 / $19.20	Professional	26	$6.48	$8.66	$19.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $26.81 / $60.56	Professional	TC	$19.00	$26.81	$60.56