Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,814.75 / $10,321.00 / $22,788.00	Facility		$1,814.75	$10,321.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $769.20 / $907.38 / $5,185.39	Facility	52	$769.20	$907.38	$5,185.39
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 $1,615.65 / $1,615.65 / $1,615.65	Facility	52	$1,615.65	$1,615.65	$1,615.65
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $201.96 / $201.96 / $201.96	Facility	AS	$201.96	$201.96	$201.96
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $944.53 / $1,429.34 / $2,538.13	Professional		$944.53	$1,429.34	$2,538.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,652.37 / $2,153.48 / $3,972.19	Professional		$1,652.37	$2,153.48	$3,972.19
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $208.86 / $263.39 / $500.00	Professional	80	$208.86	$263.39	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $208.86 / $208.86 / $263.39	Professional	AS	$208.86	$208.86	$263.39
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $16,257.04 / $16,686.80	Facility		$55.00	$16,257.04	$16,686.80
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,803.81 / $6,572.37 / $6,976.69	Facility	52	$2,803.81	$6,572.37	$6,976.69
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $350.48 / $821.55 / $872.09	Facility	AS	$350.48	$821.55	$872.09
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,613.07 / $2,133.19 / $2,982.87	Facility		$1,613.07	$2,133.19	$2,982.87
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,615.65 / $1,615.65 / $1,615.65	Facility	52	$1,615.65	$1,615.65	$1,615.65
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $694.31 / $694.31 / $694.31	Facility	80	$694.31	$694.31	$694.31
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $201.96 / $201.96 / $590.16	Facility	AS	$201.96	$201.96	$590.16
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