Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,877.54 / $10,070.00 / $22,788.00	Facility		$1,877.54	$10,070.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $792.64 / $938.77 / $5,339.00	Facility	52	$792.64	$938.77	$5,339.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $9,771.00 / $21,405.00	Facility		$2,873.70	$9,771.00	$21,405.00
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 $1,648.76 / $1,648.76 / $1,648.76	Facility	52	$1,648.76	$1,648.76	$1,648.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $206.10 / $206.10 / $206.10	Facility	AS	$206.10	$206.10	$206.10
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,096.42 / $1,659.22 / $2,618.56	Professional		$1,096.42	$1,659.22	$2,618.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,698.20 / $2,214.96 / $4,182.95	Professional		$1,698.20	$2,214.96	$4,182.95
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $241.21 / $304.19 / $500.00	Professional	80	$241.21	$304.19	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $241.21 / $241.21 / $304.19	Professional	AS	$241.21	$241.21	$304.19
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $16,659.20 / $17,063.68	Facility		$55.00	$16,659.20	$17,063.68
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,867.89 / $6,724.98 / $7,170.18	Facility	52	$2,867.89	$6,724.98	$7,170.18
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $358.49 / $840.62 / $896.27	Facility	AS	$358.49	$840.62	$896.27
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,748.71 / $2,232.73 / $3,113.37	Facility		$1,748.71	$2,232.73	$3,113.37
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,648.76 / $1,648.76 / $1,648.76	Facility	52	$1,648.76	$1,648.76	$1,648.76
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $707.15 / $707.15 / $707.15	Facility	80	$707.15	$707.15	$707.15
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $206.10 / $206.10 / $601.08	Facility	AS	$206.10	$206.10	$601.08
United Facility/Professional Facility Modifier Low / Median / High Price $1,720.00 / $5,978.00 / $18,709.00	Facility		$1,720.00	$5,978.00	$18,709.00