Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,616.00 / $9,384.00 / $20,509.00	Facility		$2,616.00	$9,384.00	$20,509.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $784.10 / $846.82 / $5,087.10	Facility	52	$784.10	$846.82	$5,087.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,652.00 / $15,165.00 / $40,316.00	Facility		$5,652.00	$15,165.00	$40,316.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $15,457.42	Facility		$64.40	$100.00	$15,457.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,984.00 / $25,197.00 / $25,198.00	Facility		$3,984.00	$25,197.00	$25,198.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,463.51 / $1,949.42 / $2,436.78	Professional		$1,463.51	$1,949.42	$2,436.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,576.85 / $2,214.26 / $4,033.00	Professional		$1,576.85	$2,214.26	$4,033.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $21,733.80 / $22,208.78	Facility		$55.00	$21,733.80	$22,208.78
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,706.64 / $6,354.39 / $6,862.69	Facility	52	$2,706.64	$6,354.39	$6,862.69
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $338.33 / $794.30 / $857.84	Facility	AS	$338.33	$794.30	$857.84
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,752.05 / $2,187.04 / $2,979.85	Facility		$1,752.05	$2,187.04	$2,979.85
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,554.50 / $1,554.50 / $1,554.50	Facility	52	$1,554.50	$1,554.50	$1,554.50
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $661.54 / $661.54 / $661.54	Facility	80	$661.54	$661.54	$661.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $194.31 / $194.31 / $562.30	Facility	AS	$194.31	$194.31	$562.30
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