Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $621.00 / $6,211.00 / $18,252.00	Facility		$621.00	$6,211.00	$18,252.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.28 / $21.40 / $116.96	Facility	52	$18.28	$21.40	$116.96
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $7.31 / $8.56 / $46.78	Facility	53	$7.31	$8.56	$46.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,516.00 / $4,343.00 / $8,557.00	Facility		$1,516.00	$4,343.00	$8,557.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $1,514.82	Facility		$67.90	$100.00	$1,514.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $316.08 / $714.30	Facility		$50.00	$316.08	$714.30
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $35.19 / $35.19 / $35.19	Facility	52	$35.19	$35.19	$35.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $8.80 / $8.80 / $8.80	Facility	53	$8.80	$8.80	$8.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $42.80 / $129.93 / $245.79	Professional		$42.80	$129.93	$245.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $47.85 / $99.00	Professional		$36.79	$47.85	$99.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,048.16 / $1,300.00	Facility		$55.00	$1,048.16	$1,300.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $73.86 / $910.60 / $910.60	Facility	52	$73.86	$910.60	$910.60
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $18.47 / $227.65 / $227.65	Facility	53	$18.47	$227.65	$227.65
Providence Facility/Professional Facility Modifier Low / Median / High Price $39.35 / $51.68 / $87.07	Facility		$39.35	$51.68	$87.07
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $35.19 / $35.19 / $35.19	Facility	52	$35.19	$35.19	$35.19
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $8.80 / $8.80 / $8.80	Facility	53	$8.80	$8.80	$8.80
United Facility/Professional Facility Modifier Low / Median / High Price $421.00 / $1,448.00 / $7,504.00	Facility		$421.00	$1,448.00	$7,504.00