Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.70 / $18.05 / $75.70	Facility	26	$13.70	$18.05	$75.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $66.48 / $283.69	Professional		$41.40	$66.48	$283.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.37 / $16.04 / $60.76	Professional	26	$10.37	$16.04	$60.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.15 / $48.89 / $92.23	Professional	TC	$29.15	$48.89	$92.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $38.44 / $60.22	Professional		$33.63	$38.44	$60.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $12.43 / $25.94	Professional	26	$8.73	$12.43	$25.94
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.19 / $60.19 / $60.19	Professional	TC	$60.19	$60.19	$60.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $71.68 / $143.38	Professional		$47.76	$71.68	$143.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.46 / $19.10 / $38.59	Professional	26	$12.46	$19.10	$38.59
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.29 / $50.72 / $102.19	Professional	TC	$35.29	$50.72	$102.19
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $47.54 / $67.59 / $132.96	Professional		$47.54	$67.59	$132.96
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.39 / $17.70 / $38.52	Professional	26	$12.39	$17.70	$38.52
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $34.95 / $49.93 / $100.06	Professional	TC	$34.95	$49.93	$100.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.54 / $75.53 / $152.94	Professional		$50.54	$75.53	$152.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $16.82 / $33.29	Professional	26	$11.88	$16.82	$33.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $58.10 / $120.40	Professional	TC	$38.86	$58.10	$120.40
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $45.03 / $50.72 / $68.47	Professional		$45.03	$50.72	$68.47
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.10 / $17.29 / $22.84	Professional	26	$11.10	$17.29	$22.84
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.02 / $39.61 / $51.51	Professional	TC	$27.02	$39.61	$51.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $46.77 / $89.47	Professional		$37.21	$46.77	$89.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $12.78 / $23.37	Professional	26	$9.14	$12.78	$23.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.72 / $41.30 / $74.38	Professional	TC	$29.72	$41.30	$74.38
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.82 / $100.00 / $100.00	Facility	26	$23.82	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $632.00 / $632.00 / $632.00	Professional		$632.00	$632.00	$632.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $223.21 / $229.91 / $229.91	Professional	26	$223.21	$229.91	$229.91
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $247.28 / $259.02 / $266.13	Professional	TC	$247.28	$259.02	$266.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.50 / $32.34 / $53.43	Professional		$14.50	$32.34	$53.43
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Providence Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $77.84 / $130.74	Professional		$51.60	$77.84	$130.74
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.23 / $16.76 / $31.96	Professional	26	$12.23	$16.76	$31.96
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $39.31 / $58.59 / $114.36	Professional	TC	$39.31	$58.59	$114.36
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $197.73 / $197.73 / $197.73	Professional		$197.73	$197.73	$197.73
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $42.56 / $42.56 / $42.56	Professional	26	$42.56	$42.56	$42.56
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $155.16 / $155.16 / $155.16	Professional	TC	$155.16	$155.16	$155.16
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $67.54 / $116.25	Professional		$42.77	$67.54	$116.25
United Facility/Professional Professional Modifier Low / Median / High Price $41.75 / $59.60 / $131.27	Professional		$41.75	$59.60	$131.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.75 / $13.91 / $28.58	Professional	26	$9.75	$13.91	$28.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.37 / $46.80 / $102.14	Professional	TC	$31.37	$46.80	$102.14