Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $238.65 / $9,665.00 / $22,788.00	Facility		$238.65	$9,665.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $102.99 / $119.33 / $667.37	Facility	52	$102.99	$119.33	$667.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,097.00 / $6,264.00 / $14,341.00	Facility		$2,097.00	$6,264.00	$14,341.00
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 $273.83 / $750.00 / $5,431.00	Facility		$273.83	$750.00	$5,431.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $26.66	Facility	AS	$26.66	$26.66	$26.66
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $200.67 / $248.80 / $335.88	Professional		$200.67	$248.80	$335.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $214.32 / $282.47 / $539.65	Professional		$214.32	$282.47	$539.65
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $44.23 / $55.78 / $500.00	Professional	80	$44.23	$55.78	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $44.23 / $44.23 / $55.78	Professional	AS	$44.23	$44.23	$55.78
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $749.71 / $1,300.00	Facility		$55.00	$749.71	$1,300.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $371.79 / $868.31 / $904.90	Facility	52	$371.79	$868.31	$904.90
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $46.47 / $108.54 / $113.11	Facility	AS	$46.47	$108.54	$113.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $229.85 / $302.25 / $536.86	Facility		$229.85	$302.25	$536.86
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $91.48 / $91.48 / $91.48	Facility	80	$91.48	$91.48	$91.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $77.76	Facility	AS	$26.66	$26.66	$77.76
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