Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $202.17 / $9,639.00 / $20,509.00	Facility		$202.17	$9,639.00	$20,509.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $91.66 / $94.93 / $581.87	Facility	52	$91.66	$94.93	$581.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,629.00 / $7,309.00 / $15,328.00	Facility		$2,629.00	$7,309.00	$15,328.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $1,693.95	Facility		$63.50	$100.00	$1,693.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $174.98 / $213.69 / $262.47	Professional		$174.98	$213.69	$262.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $198.88 / $258.73 / $466.81	Professional		$198.88	$258.73	$466.81
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $471.51 / $983.16	Facility		$55.00	$471.51	$983.16
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $327.75 / $764.18 / $786.53	Facility	52	$327.75	$764.18	$786.53
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $256.06 / $597.02 / $614.48	Facility	62	$256.06	$597.02	$614.48
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $40.97 / $95.52 / $98.32	Facility	AS	$40.97	$95.52	$98.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $201.15 / $249.87 / $341.90	Facility		$201.15	$249.87	$341.90
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $316.18 / $316.18 / $316.18	Facility	62	$316.18	$316.18	$316.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $80.94 / $80.94 / $80.94	Facility	80	$80.94	$80.94	$80.94
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $68.80 / $68.80 / $68.80	Facility	AS	$68.80	$68.80	$68.80
United Facility/Professional Facility Modifier Low / Median / High Price $2,009.00 / $5,159.00 / $20,279.00	Facility		$2,009.00	$5,159.00	$20,279.00