Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.00 / $6,218.00 / $17,809.00	Facility		$1,174.00	$6,218.00	$17,809.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $112.35 / $133.59 / $579.60	Facility	52	$112.35	$133.59	$579.60
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.94 / $53.43 / $231.84	Facility	53	$44.94	$53.43	$231.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $5,793.00 / $11,233.00	Facility		$1,196.00	$5,793.00	$11,233.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $6,539.15	Facility		$67.90	$100.00	$6,539.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $455.00 / $1,091.68 / $3,039.51	Facility		$455.00	$1,091.68	$3,039.51
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $217.20 / $242.00 / $457.77	Professional		$217.20	$242.00	$457.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $184.50 / $239.95 / $456.87	Professional		$184.50	$239.95	$456.87
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 $1,095.54 / $4,901.45 / $16,394.00	Facility		$1,095.54	$4,901.45	$16,394.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $358.02 / $3,716.72 / $3,716.72	Facility	52	$358.02	$3,716.72	$3,716.72
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $89.50 / $929.18 / $929.18	Facility	53	$89.50	$929.18	$929.18
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $279.70 / $2,903.69 / $2,903.69	Facility	62	$279.70	$2,903.69	$2,903.69
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $44.75 / $464.59 / $464.59	Facility	AS	$44.75	$464.59	$464.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $202.94 / $273.85 / $520.80	Facility		$202.94	$273.85	$520.80
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $294.60	Facility	62	$137.94	$137.94	$294.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $75.42 / $75.42 / $75.42	Facility	80	$75.42	$75.42	$75.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $64.09	Facility	AS	$22.07	$22.07	$64.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,433.90 / $3,928.00 / $9,131.00	Facility		$1,433.90	$3,928.00	$9,131.00