Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $67.61 / $194.98	Professional		$58.88	$67.61	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.88 / $47.86	Professional	26	$20.42	$33.88	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $109.65	Professional		$87.10	$87.10	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.44 / $29.51	Professional	26	$23.44	$23.44	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $79.43	Professional	TC	$63.10	$63.10	$79.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $309.03 / $1,995.26	Professional		$61.66	$309.03	$1,995.26
Lucent Health Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $630.96 / $630.96	Professional		$467.74	$630.96	$630.96
Lucent Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $169.82 / $169.82	Professional	26	$125.89	$169.82	$169.82
Lucent Health Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $467.74 / $467.74	Professional	TC	$338.84	$467.74	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $83.18	Professional		$23.99	$33.11	$83.18
Providence Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $138.04 / $158.49	Professional		$123.03	$138.04	$158.49
Sutter Health Plus Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Professional		$251.19	$251.19	$251.19
Sutter Health Plus Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	26	$67.61	$67.61	$67.61
Sutter Health Plus Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	TC	$186.21	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $95.50 / $218.78	Professional		$75.86	$95.50	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $25.70 / $47.86	Professional	26	$14.79	$25.70	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $169.82	Professional	TC	$54.95	$75.86	$169.82