Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,657.52 / $10,321.00 / $22,788.00	Facility		$3,657.52	$10,321.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,275.00 / $11,276.00 / $24,301.00	Facility		$3,275.00	$11,276.00	$24,301.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,487.90	Facility		$63.90	$100.00	$5,487.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $766.00 / $5,431.00	Facility		$633.00	$766.00	$5,431.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $2,448.96 / $2,448.96 / $2,448.96	Facility	62	$2,448.96	$2,448.96	$2,448.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $391.83 / $391.83 / $391.83	Facility	AS	$391.83	$391.83	$391.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3,042.06 / $3,671.18 / $4,772.53	Professional		$3,042.06	$3,671.18	$4,772.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $3,154.22 / $4,118.71 / $8,003.17	Professional		$3,154.22	$4,118.71	$8,003.17
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $669.17 / $669.17 / $669.17	Professional	AS	$669.17	$669.17	$669.17
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $52,146.24 / $64,529.44	Facility		$2,800.00	$52,146.24	$64,529.44
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $4,260.18 / $9,961.85 / $10,404.54	Facility	62	$4,260.18	$9,961.85	$10,404.54
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $681.63 / $1,593.90 / $1,664.73	Facility	AS	$681.63	$1,593.90	$1,664.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $3,328.82 / $4,205.63 / $5,873.89	Facility		$3,328.82	$4,205.63	$5,873.89
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,448.96 / $2,448.96 / $5,249.61	Facility	62	$2,448.96	$2,448.96	$5,249.61
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $391.83 / $391.83 / $1,142.32	Facility	AS	$391.83	$391.83	$1,142.32
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00