Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,843.00 / $9,674.00 / $21,564.38	Facility		$2,843.00	$9,674.00	$21,564.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,597.00 / $13,619.00 / $51,758.00	Facility		$4,597.00	$13,619.00	$51,758.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $65.80 / $100.00 / $7,386.46	Facility		$65.80	$100.00	$7,386.46
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 $943.78 / $1,439.84 / $1,799.80	Professional		$943.78	$1,439.84	$1,799.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,178.44 / $1,636.73 / $2,967.63	Professional		$1,178.44	$1,636.73	$2,967.63
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $13,387.11 / $16,419.37	Facility		$5,000.00	$13,387.11	$16,419.37
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,577.50 / $3,722.09 / $3,980.62	Facility	62	$1,577.50	$3,722.09	$3,980.62
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $252.40 / $595.54 / $636.90	Facility	AS	$252.40	$595.54	$636.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,309.52 / $1,622.06 / $2,310.00	Facility		$1,309.52	$1,622.06	$2,310.00
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $908.75 / $908.75 / $1,903.61	Facility	62	$908.75	$908.75	$1,903.61
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $487.32 / $487.32 / $487.32	Facility	80	$487.32	$487.32	$487.32
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $145.40 / $145.40 / $414.23	Facility	AS	$145.40	$145.40	$414.23
United Facility/Professional Facility Modifier Low / Median / High Price $8,830.00 / $18,191.00 / $43,423.00	Facility		$8,830.00	$18,191.00	$43,423.00