Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.24 / $12.45 / $71.31	Facility	26	$11.24	$12.45	$71.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.52 / $46.22 / $84.60	Professional		$40.52	$46.22	$84.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $12.94 / $33.77	Professional	26	$11.24	$12.94	$33.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $32.89 / $62.60	Professional	TC	$29.00	$32.89	$62.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.39 / $43.61 / $66.62	Professional		$14.39	$43.61	$66.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.89 / $10.87 / $19.25	Professional	26	$9.89	$10.87	$19.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $54.46 / $109.14	Professional		$42.98	$54.46	$109.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $14.39 / $28.95	Professional	26	$11.49	$14.39	$28.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.08 / $40.06 / $79.29	Professional	TC	$31.08	$40.06	$79.29
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $35.21 / $50.14 / $100.00	Professional		$35.21	$50.14	$100.00
Blue Shield Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $13.36 / $31.99	Professional	26	$9.35	$13.36	$31.99
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.81 / $36.31 / $85.42	Professional	TC	$25.81	$36.31	$85.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.75 / $60.12 / $128.02	Professional		$45.75	$60.12	$128.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.68 / $16.26 / $32.85	Professional	26	$12.68	$16.26	$32.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.90 / $43.71 / $94.49	Professional	TC	$32.90	$43.71	$94.49
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $58.55 / $79.04	Professional		$37.61	$58.55	$79.04
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $12.97 / $17.51	Professional	26	$10.16	$12.97	$17.51
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.46 / $45.58 / $61.53	Professional	TC	$27.46	$45.58	$61.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $53.73 / $89.97	Professional		$42.70	$53.73	$89.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $14.92 / $27.28	Professional	26	$10.68	$14.92	$27.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.47 / $47.49 / $85.56	Professional	TC	$33.47	$47.49	$85.56
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $70.00 / $85.00	Facility	26	$27.92	$70.00	$85.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $277.95 / $277.95 / $377.85	Professional		$277.95	$277.95	$377.85
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.58 / $74.58 / $93.83	Professional	26	$74.58	$74.58	$93.83
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $203.39 / $203.39 / $284.02	Professional	TC	$203.39	$203.39	$284.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.91 / $32.34 / $61.19	Professional		$16.91	$32.34	$61.19
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $46.70 / $67.06 / $115.91	Professional		$46.70	$67.06	$115.91
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $15.96 / $30.54	Professional	26	$12.71	$15.96	$30.54
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $32.85 / $43.21 / $83.87	Professional	TC	$32.85	$43.21	$83.87
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $145.44 / $145.44 / $145.44	Professional		$145.44	$145.44	$145.44
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $40.21 / $40.21 / $40.21	Professional	26	$40.21	$40.21	$40.21
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $105.23 / $105.23 / $105.23	Professional	TC	$105.23	$105.23	$105.23
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $53.27 / $65.11	Professional		$37.61	$53.27	$65.11
United Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $46.61 / $107.59	Professional		$34.18	$46.61	$107.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $13.00 / $28.06	Professional	26	$9.44	$13.00	$28.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $33.35 / $73.89	Professional	TC	$24.36	$33.35	$73.89