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 / $73.75	Facility	26	$11.24	$12.45	$73.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $44.04 / $77.09	Professional		$37.03	$44.04	$77.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $12.62 / $18.69	Professional	26	$11.06	$12.62	$18.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.15 / $30.44 / $59.65	Professional	TC	$25.15	$30.44	$59.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $42.30 / $42.30	Professional		$42.30	$42.30	$42.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $54.46 / $109.14	Professional		$42.14	$54.46	$109.14
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.49 / $14.50 / $28.95	Professional	26	$11.49	$14.50	$28.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.90 / $40.06 / $79.29	Professional	TC	$29.90	$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 / $32.43	Professional	26	$9.35	$13.36	$32.43
Blue Shield Facility/Professional Professional Modifier TC Low / Median / High Price $25.81 / $36.31 / $84.71	Professional	TC	$25.81	$36.31	$84.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.93 / $58.55 / $118.56	Professional		$43.93	$58.55	$118.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $16.55 / $33.84	Professional	26	$12.87	$16.55	$33.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.74 / $42.00 / $84.95	Professional	TC	$30.74	$42.00	$84.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $37.61 / $57.63 / $74.92	Professional		$37.61	$57.63	$74.92
Contra Costa Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $13.43 / $18.13	Professional	26	$10.16	$13.43	$18.13
Contra Costa Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.46 / $44.21 / $57.47	Professional	TC	$27.46	$44.21	$57.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.05 / $52.49 / $101.00	Professional		$42.05	$52.49	$101.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.03 / $15.44 / $28.15	Professional	26	$11.03	$15.44	$28.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $46.06 / $82.98	Professional	TC	$32.47	$46.06	$82.98
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $28.55 / $70.00 / $85.00	Facility	26	$28.55	$70.00	$85.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $251.93 / $251.93 / $372.23	Professional		$251.93	$251.93	$372.23
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $76.73 / $76.73 / $96.68	Professional	26	$76.73	$76.73	$96.68
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $175.19 / $175.19 / $275.55	Professional	TC	$175.19	$175.19	$275.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.36 / $32.34 / $60.75	Professional		$17.36	$32.34	$60.75
Providence Facility/Professional Facility Modifier 26 Low / Median / High Price $13.91 / $13.91 / $13.91	Facility	26	$13.91	$13.91	$13.91
Providence Facility/Professional Professional Modifier Low / Median / High Price $44.89 / $63.72 / $110.46	Professional		$44.89	$63.72	$110.46
Providence Facility/Professional Professional Modifier 26 Low / Median / High Price $12.87 / $16.13 / $31.36	Professional	26	$12.87	$16.13	$31.36
Providence Facility/Professional Professional Modifier TC Low / Median / High Price $31.36 / $41.56 / $76.17	Professional	TC	$31.36	$41.56	$76.17
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $135.83 / $135.83 / $135.83	Professional		$135.83	$135.83	$135.83
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $41.41 / $41.41 / $41.41	Professional	26	$41.41	$41.41	$41.41
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $94.41 / $94.41 / $94.41	Professional	TC	$94.41	$94.41	$94.41
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $52.67 / $71.56	Professional		$46.61	$52.67	$71.56
United Facility/Professional Professional Modifier Low / Median / High Price $31.99 / $44.35 / $99.61	Professional		$31.99	$44.35	$99.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.76 / $13.32 / $27.80	Professional	26	$9.76	$13.32	$27.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $31.23 / $66.01	Professional	TC	$22.11	$31.23	$66.01