Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,753.86 / $9,992.02 / $22,788.00	Facility		$1,753.86	$9,992.02	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $747.12 / $876.93 / $4,996.01	Facility	52	$747.12	$876.93	$4,996.01
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 $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $196.33 / $196.33	Facility	AS	$196.33	$196.33	$196.33
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $843.26 / $1,276.09 / $2,457.87	Professional		$843.26	$1,276.09	$2,457.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,604.88 / $2,093.34 / $3,846.13	Professional		$1,604.88	$2,093.34	$3,846.13
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $185.51 / $233.95 / $500.00	Professional	80	$185.51	$233.95	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $185.52 / $185.52 / $233.95	Professional	AS	$185.52	$185.52	$233.95
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $15,834.88 / $16,222.96	Facility		$55.00	$15,834.88	$16,222.96
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,733.66 / $6,402.84 / $6,776.16	Facility	52	$2,733.66	$6,402.84	$6,776.16
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $341.71 / $800.36 / $847.02	Facility	AS	$341.71	$800.36	$847.02
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,596.12 / $2,072.21 / $2,930.67	Facility		$1,596.12	$2,072.21	$2,930.67
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $672.98 / $672.98 / $672.98	Facility	80	$672.98	$672.98	$672.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $196.33 / $572.03	Facility	AS	$196.33	$196.33	$572.03
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