Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,671.61 / $9,665.00 / $21,479.00	Facility		$2,671.61	$9,665.00	$21,479.00
Aetna Facility/Professional Facility Modifier 62 Low / Median / High Price $12,363.55 / $12,363.55 / $12,363.55	Facility	62	$12,363.55	$12,363.55	$12,363.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,840.00 / $10,165.00 / $25,530.00	Facility		$3,840.00	$10,165.00	$25,530.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $16,129.57	Facility		$66.70	$100.00	$16,129.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,500.00 / $27,565.81 / $49,371.60	Facility		$8,500.00	$27,565.81	$49,371.60
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,192.48 / $1,743.44 / $19,680.04	Professional		$1,192.48	$1,743.44	$19,680.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,435.31 / $1,993.49 / $3,622.73	Professional		$1,435.31	$1,993.49	$3,622.73
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $11,000.00 / $45,000.00 / $79,615.70	Facility		$11,000.00	$45,000.00	$79,615.70
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,172.83 / $47,165.25 / $47,165.25	Facility	62	$2,172.83	$47,165.25	$47,165.25
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $347.65 / $7,546.44 / $7,546.44	Facility	AS	$347.65	$7,546.44	$7,546.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,631.06 / $2,024.29 / $2,940.00	Facility		$1,631.06	$2,024.29	$2,940.00
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,113.57 / $1,113.57 / $2,361.83	Facility	62	$1,113.57	$1,113.57	$2,361.83
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $604.63 / $604.63 / $604.63	Facility	80	$604.63	$604.63	$604.63
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $178.17 / $178.17 / $513.92	Facility	AS	$178.17	$178.17	$513.92
United Facility/Professional Facility Modifier Low / Median / High Price $7,696.00 / $13,784.00 / $29,312.00	Facility		$7,696.00	$13,784.00	$29,312.00