Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,390.35 / $6,423.00 / $18,483.00	Facility		$1,390.35	$6,423.00	$18,483.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $178.06 / $178.06 / $731.09	Facility	52	$178.06	$178.06	$731.09
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $71.22 / $71.22 / $292.44	Facility	53	$71.22	$71.22	$292.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,196.00 / $5,793.00 / $11,233.00	Facility		$1,196.00	$5,793.00	$11,233.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $552.98 / $4,886.39	Facility		$67.90	$552.98	$4,886.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $900.00 / $2,656.00	Facility		$633.00	$900.00	$2,656.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $221.01 / $221.01 / $221.01	Facility	52	$221.01	$221.01	$221.01
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.25 / $55.25 / $55.25	Facility	53	$55.25	$55.25	$55.25
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $271.57 / $298.73 / $887.44	Professional		$271.57	$298.73	$887.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $228.40 / $300.04 / $560.00	Professional		$228.40	$300.04	$560.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,133.60 / $3,590.15	Facility		$55.00	$3,133.60	$3,590.15
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $453.79 / $2,722.36 / $2,722.36	Facility	52	$453.79	$2,722.36	$2,722.36
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $113.45 / $680.59 / $680.59	Facility	53	$113.45	$680.59	$680.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $247.42 / $313.14 / $509.25	Facility		$247.42	$313.14	$509.25
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $221.01 / $221.01 / $221.01	Facility	52	$221.01	$221.01	$221.01
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $55.25 / $55.25 / $55.25	Facility	53	$55.25	$55.25	$55.25
United Facility/Professional Facility Modifier Low / Median / High Price $1,089.45 / $3,964.00 / $9,131.00	Facility		$1,089.45	$3,964.00	$9,131.00