Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,256.22 / $5,382.00 / $17,328.00	Facility		$1,256.22	$5,382.00	$17,328.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $6,978.00 / $13,707.00	Facility		$2,456.00	$6,978.00	$13,707.00
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 $342.14 / $393.46 / $513.21	Professional		$342.14	$393.46	$513.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.32 / $443.74 / $804.48	Professional		$323.32	$443.74	$804.48
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,682.85 / $5,000.00 / $5,747.42	Facility		$4,682.85	$5,000.00	$5,747.42
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $435.46 / $1,020.88 / $1,066.49	Facility	62	$435.46	$1,020.88	$1,066.49
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $69.67 / $163.34 / $170.64	Facility	AS	$69.67	$163.34	$170.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $360.14 / $450.98 / $673.04	Facility		$360.14	$450.98	$673.04
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $250.26 / $250.26 / $531.99	Facility	62	$250.26	$250.26	$531.99
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $136.19 / $136.19 / $136.19	Facility	80	$136.19	$136.19	$136.19
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $40.04 / $40.04 / $115.76	Facility	AS	$40.04	$40.04	$115.76
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $7,935.00	Facility		$587.00	$1,551.00	$7,935.00