Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.70 / $15.02 / $86.00	Facility	26	$13.70	$15.02	$86.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.59 / $43.34 / $162.00	Professional		$35.59	$43.34	$162.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.30 / $15.36 / $57.64	Professional	26	$13.30	$15.36	$57.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.36 / $26.09 / $46.85	Professional	TC	$22.36	$26.09	$46.85
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.25 / $39.01 / $47.67	Professional		$33.25	$39.01	$47.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $14.53 / $17.52	Professional	26	$13.39	$14.53	$17.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.18 / $46.93 / $92.79	Professional		$37.18	$46.93	$92.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $19.30 / $37.01	Professional	26	$14.20	$19.30	$37.01
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.54 / $27.77 / $56.07	Professional	TC	$22.54	$27.77	$56.07
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $30.85 / $43.59 / $100.00	Professional		$30.85	$43.59	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $12.61 / $18.02 / $41.91	Professional	26	$12.61	$18.02	$41.91
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $25.56 / $59.88	Professional	TC	$17.89	$25.56	$59.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.50 / $51.06 / $113.22	Professional		$38.50	$51.06	$113.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.97 / $18.92 / $39.17	Professional	26	$14.97	$18.92	$39.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $32.61 / $70.23	Professional	TC	$23.93	$32.61	$70.23
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $23.22 / $49.75 / $64.68	Professional		$23.22	$49.75	$64.68
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.28 / $15.64 / $21.11	Professional	26	$9.28	$15.64	$21.11
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.93 / $34.11 / $44.34	Professional	TC	$13.93	$34.11	$44.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $45.62 / $84.28	Professional		$36.42	$45.62	$84.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $17.98 / $32.86	Professional	26	$12.86	$17.98	$32.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.07 / $35.56 / $64.06	Professional	TC	$25.07	$35.56	$64.06
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.53 / $100.00 / $100.00	Facility	26	$33.53	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $348.00 / $348.00 / $348.00	Professional		$348.00	$348.00	$348.00
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.60 / $89.60 / $112.43	Professional	26	$89.60	$89.60	$112.43
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $198.00 / $198.00 / $213.38	Professional	TC	$198.00	$198.00	$213.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.26 / $32.34 / $53.84	Professional		$20.26	$32.34	$53.84
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $16.25 / $16.25 / $16.25	Facility	26	$16.25	$16.25	$16.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $39.76 / $55.50 / $101.53	Professional		$39.76	$55.50	$101.53
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $18.57 / $36.58	Professional	26	$14.92	$18.57	$36.58
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $23.40 / $32.15 / $65.18	Professional	TC	$23.40	$32.15	$65.18
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $129.57 / $129.57 / $129.57	Professional		$129.57	$129.57	$129.57
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $48.37 / $48.37 / $48.37	Professional	26	$48.37	$48.37	$48.37
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $81.19 / $81.19 / $81.19	Professional	TC	$81.19	$81.19	$81.19
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $45.26 / $63.37	Professional		$33.31	$45.26	$63.37
United Facility/Professional Professional Modifier Low / Median / High Price $29.75 / $39.96 / $89.69	Professional		$29.75	$39.96	$89.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.34 / $15.16 / $32.22	Professional	26	$11.34	$15.16	$32.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.63 / $24.54 / $57.02	Professional	TC	$18.63	$24.54	$57.02