Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,661.79 / $9,674.00 / $22,788.00	Facility		$1,661.79	$9,674.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $705.85 / $830.90 / $4,711.72	Facility	52	$705.85	$830.90	$4,711.72
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 / $7,344.10	Facility		$63.90	$100.00	$7,344.10
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 $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $183.95	Facility	AS	$183.95	$183.95	$183.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $877.14 / $1,327.37 / $2,301.44	Professional		$877.14	$1,327.37	$2,301.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,502.55 / $1,959.16 / $3,649.00	Professional		$1,502.55	$1,959.16	$3,649.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $194.93 / $245.83 / $500.00	Professional	80	$194.93	$245.83	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $194.93 / $194.93 / $245.83	Professional	AS	$194.93	$194.93	$245.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $14,819.60 / $15,195.36	Facility		$55.00	$14,819.60	$15,195.36
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,558.76 / $5,994.70 / $6,344.10	Facility	52	$2,558.76	$5,994.70	$6,344.10
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $319.85 / $749.34 / $793.01	Facility	AS	$319.85	$749.34	$793.01
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,567.33 / $1,976.99 / $2,754.68	Facility		$1,567.33	$1,976.99	$2,754.68
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $632.76 / $632.76 / $632.76	Facility	80	$632.76	$632.76	$632.76
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $537.85	Facility	AS	$183.95	$183.95	$537.85
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