Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,336.71 / $9,674.00 / $22,788.00	Facility		$1,336.71	$9,674.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $568.58 / $668.36 / $3,794.46	Facility	52	$568.58	$668.36	$3,794.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $8,947.00 / $19,298.00	Facility		$2,873.70	$8,947.00	$19,298.00
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 52 Low / Median / High Price $1,198.39 / $1,198.39 / $1,198.39	Facility	52	$1,198.39	$1,198.39	$1,198.39
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $149.80 / $149.80 / $149.80	Facility	AS	$149.80	$149.80	$149.80
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $759.12 / $1,148.77 / $1,879.19	Professional		$759.12	$1,148.77	$1,879.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,226.30 / $1,598.80 / $2,928.20	Professional		$1,226.30	$1,598.80	$2,928.20
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $167.09 / $210.72 / $500.00	Professional	80	$167.09	$210.72	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $167.09 / $167.09 / $210.72	Professional	AS	$167.09	$167.09	$210.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $12,089.92 / $12,372.96	Facility		$55.00	$12,089.92	$12,372.96
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,087.11 / $4,890.22 / $5,177.72	Facility	52	$2,087.11	$4,890.22	$5,177.72
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $260.89 / $611.28 / $647.22	Facility	AS	$260.89	$611.28	$647.22
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,279.04 / $1,654.43 / $2,310.32	Facility		$1,279.04	$1,654.43	$2,310.32
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,198.39 / $1,198.39 / $1,198.39	Facility	52	$1,198.39	$1,198.39	$1,198.39
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $513.02 / $513.02 / $513.02	Facility	80	$513.02	$513.02	$513.02
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $149.80 / $149.80 / $436.07	Facility	AS	$149.80	$149.80	$436.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $4,675.00 / $20,279.00	Facility		$1,204.00	$4,675.00	$20,279.00