Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.03 / $5.46 / $27.74	Facility	26	$5.03	$5.46	$27.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.54 / $24.71 / $36.99	Professional		$14.54	$24.71	$36.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.75 / $5.03 / $12.68	Professional	26	$2.75	$5.03	$12.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.80 / $19.69 / $29.76	Professional	TC	$11.80	$19.69	$29.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.71 / $12.71 / $15.97	Professional		$12.71	$12.71	$15.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $2.68 / $2.68 / $3.15	Professional	26	$2.68	$2.68	$3.15
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.02 / $26.77 / $52.03	Professional		$20.02	$26.77	$52.03
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $4.53 / $6.85 / $13.85	Professional	26	$4.53	$6.85	$13.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $13.21 / $19.76 / $39.78	Professional	TC	$13.21	$19.76	$39.78
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $19.02 / $27.11 / $59.76	Professional		$19.02	$27.11	$59.76
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $4.49 / $6.42 / $13.53	Professional	26	$4.49	$6.42	$13.53
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $14.49 / $20.70 / $47.17	Professional	TC	$14.49	$20.70	$47.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.06 / $3.06 / $3.06	Facility	26	$3.06	$3.06	$3.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.46 / $29.57 / $59.80	Professional		$19.46	$29.57	$59.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.82 / $6.21 / $11.67	Professional	26	$3.82	$6.21	$11.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.73 / $23.37 / $48.55	Professional	TC	$15.73	$23.37	$48.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $16.39 / $19.48 / $26.31	Professional		$16.39	$19.48	$26.31
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.82 / $4.51 / $8.86	Professional	26	$2.82	$4.51	$8.86
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.84 / $16.67 / $21.67	Professional	TC	$9.84	$16.67	$21.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $14.29 / $18.00 / $36.97	Professional		$14.29	$18.00	$36.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $2.35 / $3.25 / $6.00	Professional	26	$2.35	$3.25	$6.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $12.28 / $17.43 / $31.37	Professional	TC	$12.28	$17.43	$31.37
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.94 / $25.37 / $100.00	Facility	26	$5.94	$25.37	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $161.00 / $161.00 / $161.00	Professional		$161.00	$161.00	$161.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $54.00 / $54.00	Professional	26	$33.02	$54.00	$54.00
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $129.00 / $129.00 / $129.00	Professional	TC	$129.00	$129.00	$129.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $5.65 / $32.34 / $32.34	Professional		$5.65	$32.34	$32.34
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $3.06 / $3.06 / $3.06	Facility	26	$3.06	$3.06	$3.06
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.62 / $30.72 / $53.24	Professional		$19.62	$30.72	$53.24
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $6.21 / $11.55	Professional	26	$3.89	$6.21	$11.55
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $16.28 / $23.53 / $46.45	Professional	TC	$16.28	$23.53	$46.45
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $74.37 / $74.37 / $74.37	Professional		$74.37	$74.37	$74.37
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $14.82 / $14.82	Professional	26	$14.82	$14.82	$14.82
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $59.55 / $59.55 / $59.55	Professional	TC	$59.55	$59.55	$59.55
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $16.36 / $24.60 / $44.75	Professional		$16.36	$24.60	$44.75
United Facility/Professional Professional Modifier Low / Median / High Price $16.02 / $23.30 / $52.01	Professional		$16.02	$23.30	$52.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.01 / $5.18 / $10.86	Professional	26	$3.01	$5.18	$10.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.73 / $18.30 / $41.82	Professional	TC	$12.73	$18.30	$41.82