Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $426.00 / $4,344.83 / $16,109.00	Facility		$426.00	$4,344.83	$16,109.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $59.42 / $76.86 / $552.78	Facility	54	$59.42	$76.86	$552.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,723.00 / $4,464.00 / $8,976.00	Facility		$1,723.00	$4,464.00	$8,976.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $1,581.82	Facility		$66.00	$100.00	$1,581.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $151.18 / $270.77	Facility		$56.00	$151.18	$270.77
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $89.72 / $113.33 / $173.36	Professional		$89.72	$113.33	$173.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $143.72 / $252.36	Professional		$97.41	$143.72	$252.36
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $437.49 / $482.46	Facility		$55.00	$437.49	$482.46
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $306.24 / $337.72 / $337.72	Facility	54	$306.24	$337.72	$337.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $96.64 / $137.90 / $205.22	Facility		$96.64	$137.90	$205.22
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $112.50 / $112.50 / $234.47	Facility	54	$112.50	$112.50	$234.47
United Facility/Professional Facility Modifier Low / Median / High Price $548.00 / $1,533.00 / $6,323.00	Facility		$548.00	$1,533.00	$6,323.00