Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $9,029.00 / $22,788.00	Facility		$2,421.00	$9,029.00	$22,788.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,849.00 / $10,349.95 / $24,018.05	Facility	50	$9,849.00	$10,349.95	$24,018.05
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $676.59 / $719.04 / $4,208.87	Facility	52	$676.59	$719.04	$4,208.87
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,486.00 / $12,600.00 / $25,864.00	Facility		$5,486.00	$12,600.00	$25,864.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $8,389.08	Facility		$63.50	$100.00	$8,389.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $801.19 / $1,212.43 / $1,962.52	Professional		$801.19	$1,212.43	$1,962.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,461.58 / $1,880.74 / $3,381.62	Professional		$1,461.58	$1,880.74	$3,381.62
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 / $9,401.98 / $11,877.88	Facility		$55.00	$9,401.98	$11,877.88
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,260.94 / $5,298.36 / $5,744.80	Facility	52	$2,260.94	$5,298.36	$5,744.80
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,766.36 / $4,139.34 / $4,488.13	Facility	62	$1,766.36	$4,139.34	$4,488.13
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $282.62 / $662.30 / $718.10	Facility	AS	$282.62	$662.30	$718.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,421.95 / $1,814.15 / $2,620.80	Facility		$1,421.95	$1,814.15	$2,620.80
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,152.04 / $2,152.04 / $2,152.04	Facility	62	$2,152.04	$2,152.04	$2,152.04
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $550.91 / $550.91 / $550.91	Facility	80	$550.91	$550.91	$550.91
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $468.28 / $468.28 / $468.28	Facility	AS	$468.28	$468.28	$468.28
United Facility/Professional Facility Modifier Low / Median / High Price $3,610.00 / $7,402.00 / $16,148.00	Facility		$3,610.00	$7,402.00	$16,148.00