Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $9,386.00 / $19,368.00	Facility		$2,421.00	$9,386.00	$19,368.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,446.00 / $11,289.00 / $26,404.93	Facility		$4,446.00	$11,289.00	$26,404.93
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $13,613.98	Facility		$63.90	$100.00	$13,613.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,702.16 / $2,608.42 / $3,260.53	Professional		$1,702.16	$2,608.42	$3,260.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,165.14 / $3,007.14 / $5,451.82	Professional		$2,165.14	$3,007.14	$5,451.82
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $24,355.26 / $24,967.80	Facility		$55.00	$24,355.26	$24,967.80
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,923.70 / $6,872.73 / $7,281.81	Facility	62	$2,923.70	$6,872.73	$7,281.81
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $467.79 / $1,099.64 / $1,165.08	Facility	AS	$467.79	$1,099.64	$1,165.08
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,369.04 / $2,979.86 / $4,014.86	Facility		$2,369.04	$2,979.86	$4,014.86
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,688.18 / $1,688.18 / $3,564.82	Facility	62	$1,688.18	$1,688.18	$3,564.82
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $912.59 / $912.59 / $912.59	Facility	80	$912.59	$912.59	$912.59
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $270.11 / $270.11 / $775.70	Facility	AS	$270.11	$270.11	$775.70
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $13,651.00 / $29,312.00	Facility		$7,212.00	$13,651.00	$29,312.00