Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,314.10 / $10,321.00 / $22,788.00	Facility		$2,314.10	$10,321.00	$22,788.00
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 / $8,393.26	Facility		$63.90	$100.00	$8,393.26
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 62 Low / Median / High Price $1,628.99 / $1,628.99 / $1,628.99	Facility	62	$1,628.99	$1,628.99	$1,628.99
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $260.64 / $260.64 / $260.64	Facility	AS	$260.64	$260.64	$260.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $801.19 / $1,212.43 / $3,254.69	Professional		$801.19	$1,212.43	$3,254.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,127.38 / $2,771.96 / $5,633.12	Professional		$2,127.38	$2,771.96	$5,633.12
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $176.10 / $222.08 / $500.00	Professional	80	$176.10	$222.08	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $176.10 / $176.10 / $222.08	Professional	AS	$176.10	$176.10	$222.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $36,730.96 / $37,624.58	Facility		$55.00	$36,730.96	$37,624.58
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,833.92 / $6,641.86 / $7,017.41	Facility	62	$2,833.92	$6,641.86	$7,017.41
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $453.43 / $1,062.70 / $1,122.79	Facility	AS	$453.43	$1,062.70	$1,122.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,042.09 / $2,783.02 / $3,958.50	Facility		$2,042.09	$2,783.02	$3,958.50
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,628.99 / $1,628.99 / $3,486.03	Facility	62	$1,628.99	$1,628.99	$3,486.03
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $892.42 / $892.42 / $892.42	Facility	80	$892.42	$892.42	$892.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $260.64 / $260.64 / $758.56	Facility	AS	$260.64	$260.64	$758.56
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