Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,237.27 / $9,674.00 / $22,788.00	Facility		$1,237.27	$9,674.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $526.12 / $618.64 / $3,517.65	Facility	52	$526.12	$618.64	$3,517.65
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 / $13,858.12	Facility		$63.90	$100.00	$13,858.12
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 $1,108.61 / $1,108.61 / $1,108.61	Facility	52	$1,108.61	$1,108.61	$1,108.61
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $138.58 / $138.58 / $138.58	Facility	AS	$138.58	$138.58	$138.58
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,340.70 / $1,474.77 / $1,809.95	Professional		$1,340.70	$1,474.77	$1,809.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,136.24 / $1,484.02 / $2,731.26	Professional		$1,136.24	$1,484.02	$2,731.26
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $11,194.88 / $11,453.28	Facility		$55.00	$11,194.88	$11,453.28
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,931.54 / $4,525.71 / $4,797.46	Facility	52	$1,931.54	$4,525.71	$4,797.46
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $241.44 / $565.71 / $599.67	Facility	AS	$241.44	$565.71	$599.67
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,185.24 / $1,538.91 / $2,322.26	Facility		$1,185.24	$1,538.91	$2,322.26
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $1,108.61 / $1,108.61 / $1,108.61	Facility	52	$1,108.61	$1,108.61	$1,108.61
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $474.22 / $474.22 / $474.22	Facility	80	$474.22	$474.22	$474.22
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $138.58 / $138.58 / $403.09	Facility	AS	$138.58	$138.58	$403.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00