Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,546.09 / $10,976.00 / $23,989.00	Facility		$3,546.09	$10,976.00	$23,989.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $383.77 / $391.02 / $2,200.71	Facility	52	$383.77	$391.02	$2,200.71
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $153.51 / $156.41 / $880.28	Facility	53	$153.51	$156.41	$880.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,598.00 / $10,000.00 / $20,418.00	Facility		$3,598.00	$10,000.00	$20,418.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $15,963.33	Facility		$63.50	$100.00	$15,963.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $678.70 / $800.90 / $1,018.05	Professional		$678.70	$800.90	$1,018.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $718.65 / $929.81 / $1,705.02	Professional		$718.65	$929.81	$1,705.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $7,777.88 / $9,664.93	Facility		$55.00	$7,777.88	$9,664.93
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,185.50 / $2,769.66 / $2,900.39	Facility	52	$1,185.50	$2,769.66	$2,900.39
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $296.38 / $692.42 / $725.10	Facility	53	$296.38	$692.42	$725.10
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $926.18 / $2,163.80 / $2,265.92	Facility	62	$926.18	$2,163.80	$2,265.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $744.37 / $934.25 / $1,290.83	Facility		$744.37	$934.25	$1,290.83
United Facility/Professional Facility Modifier Low / Median / High Price $5,830.00 / $12,377.00 / $26,672.00	Facility		$5,830.00	$12,377.00	$26,672.00