Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,919.00 / $5,829.00 / $17,013.00	Facility		$1,919.00	$5,829.00	$17,013.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $265.76 / $285.07 / $1,739.67	Facility	52	$265.76	$285.07	$1,739.67
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $398.63 / $427.60 / $2,609.50	Facility	54	$398.63	$427.60	$2,609.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,597.00 / $9,381.00	Facility		$1,723.00	$4,597.00	$9,381.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,919.63	Facility		$66.00	$100.00	$6,919.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,646.28 / $1,649.19 / $2,948.55	Facility		$1,646.28	$1,649.19	$2,948.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $461.28 / $687.47 / $928.08	Professional		$461.28	$687.47	$928.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $563.69 / $768.01 / $1,377.90	Professional		$563.69	$768.01	$1,377.90
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,743.45 / $4,754.80 / $16,394.00	Facility		$2,743.45	$4,754.80	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,068.68 / $3,605.48 / $3,605.48	Facility	52	$1,068.68	$3,605.48	$3,605.48
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $935.09 / $3,154.80 / $3,154.80	Facility	54	$935.09	$3,154.80	$3,154.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $584.84 / $741.07 / $1,023.47	Facility		$584.84	$741.07	$1,023.47
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $530.59 / $530.59 / $530.59	Facility	52	$530.59	$530.59	$530.59
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $464.27 / $464.27 / $1,121.63	Facility	54	$464.27	$464.27	$1,121.63
United Facility/Professional Facility Modifier Low / Median / High Price $2,090.00 / $4,060.00 / $9,131.00	Facility		$2,090.00	$4,060.00	$9,131.00