Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.00 / $5,308.00 / $17,133.00	Facility		$1,169.00	$5,308.00	$17,133.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,294.00 / $8,541.00 / $16,838.00	Facility		$3,294.00	$8,541.00	$16,838.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,455.40	Facility		$63.90	$100.00	$5,455.40
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 $367.83 / $556.64 / $983.33	Professional		$367.83	$556.64	$983.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $669.59 / $914.69 / $1,686.03	Professional		$669.59	$914.69	$1,686.03
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,500.00 / $9,834.16 / $12,069.26	Facility		$5,500.00	$9,834.16	$12,069.26
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $913.51 / $2,142.04 / $2,231.14	Facility	62	$913.51	$2,142.04	$2,231.14
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $146.16 / $342.73 / $356.98	Facility	AS	$146.16	$342.73	$356.98
Providence Facility/Professional Facility Modifier Low / Median / High Price $786.18 / $949.87 / $1,407.22	Facility		$786.18	$949.87	$1,407.22
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $526.61 / $526.61 / $1,123.19	Facility	62	$526.61	$526.61	$1,123.19
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $287.54 / $287.54 / $287.54	Facility	80	$287.54	$287.54	$287.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $84.26 / $84.26 / $244.41	Facility	AS	$84.26	$84.26	$244.41
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,572.00 / $6,323.00	Facility		$587.00	$1,572.00	$6,323.00