Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,843.00 / $9,384.00 / $19,368.00	Facility		$2,843.00	$9,384.00	$19,368.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $47,424.77 / $47,424.77 / $47,424.77	Facility	50	$47,424.77	$47,424.77	$47,424.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,437.00 / $11,059.00 / $24,104.86	Facility		$4,437.00	$11,059.00	$24,104.86
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.20 / $100.00 / $13,108.07	Facility		$64.20	$100.00	$13,108.07
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,707.74 / $2,584.32 / $3,660.60	Professional		$1,707.74	$2,584.32	$3,660.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,733.80 / $3,462.16 / $7,016.15	Professional		$2,733.80	$3,462.16	$7,016.15
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,897.00 / $15,105.12 / $18,900.41	Facility		$5,897.00	$15,105.12	$18,900.41
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $3,299.82 / $7,746.01 / $8,379.33	Facility	62	$3,299.82	$7,746.01	$8,379.33
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $527.97 / $1,239.35 / $1,340.69	Facility	AS	$527.97	$1,239.35	$1,340.69
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,769.72 / $3,497.24 / $4,766.85	Facility		$2,769.72	$3,497.24	$4,766.85
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $4,038.59 / $4,038.59 / $4,038.59	Facility	62	$4,038.59	$4,038.59	$4,038.59
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,033.88 / $1,033.88 / $1,033.88	Facility	80	$1,033.88	$1,033.88	$1,033.88
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $878.80 / $878.80 / $878.80	Facility	AS	$878.80	$878.80	$878.80
United Facility/Professional Facility Modifier Low / Median / High Price $5,416.00 / $12,341.00 / $26,672.00	Facility		$5,416.00	$12,341.00	$26,672.00