Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,089.46 / $9,674.00 / $22,330.11	Facility		$3,089.46	$9,674.00	$22,330.11
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $703.22 / $744.22 / $4,441.18	Facility	52	$703.22	$744.22	$4,441.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,675.00 / $13,255.00 / $41,473.83	Facility		$4,675.00	$13,255.00	$41,473.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $8,824.82	Facility		$64.40	$100.00	$8,824.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,000.00 / $20,814.00 / $25,978.00	Facility		$11,000.00	$20,814.00	$25,978.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,707.76 / $1,878.54 / $2,305.48	Professional		$1,707.76	$1,878.54	$2,305.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,397.06 / $1,940.50 / $3,530.00	Professional		$1,397.06	$1,940.50	$3,530.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $19,057.39 / $19,447.78	Facility		$55.00	$19,057.39	$19,447.78
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,374.85 / $5,576.91 / $6,016.39	Facility	52	$2,374.85	$5,576.91	$6,016.39
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $296.86 / $697.11 / $752.05	Facility	AS	$296.86	$697.11	$752.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,583.26 / $1,996.96 / $3,008.00	Facility		$1,583.26	$1,996.96	$3,008.00
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,362.43 / $1,362.43 / $1,362.43	Facility	52	$1,362.43	$1,362.43	$1,362.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $579.05 / $579.05 / $579.05	Facility	80	$579.05	$579.05	$579.05
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $170.30 / $170.30 / $492.20	Facility	AS	$170.30	$170.30	$492.20
United Facility/Professional Facility Modifier Low / Median / High Price $9,252.00 / $18,646.00 / $42,098.00	Facility		$9,252.00	$18,646.00	$42,098.00