Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,956.72 / $8,499.00 / $20,509.00	Facility		$1,956.72	$8,499.00	$20,509.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $455.89 / $538.70 / $3,035.54	Facility	52	$455.89	$538.70	$3,035.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $9,771.00 / $21,405.00	Facility		$2,456.00	$9,771.00	$21,405.00
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 $959.49 / $959.49 / $959.49	Facility	52	$959.49	$959.49	$959.49
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $119.94 / $119.94 / $119.94	Facility	AS	$119.94	$119.94	$119.94
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $576.69 / $872.71 / $1,513.47	Professional		$576.69	$872.71	$1,513.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $985.63 / $1,283.69 / $2,369.14	Professional		$985.63	$1,283.69	$2,369.14
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $126.95 / $160.11 / $500.00	Professional	80	$126.95	$160.11	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $126.95 / $126.95 / $160.11	Professional	AS	$126.95	$126.95	$160.11
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,413.00 / $8,558.00 / $9,898.71	Facility		$5,413.00	$8,558.00	$9,898.71
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,672.72 / $3,923.82 / $4,161.54	Facility	52	$1,672.72	$3,923.82	$4,161.54
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $209.09 / $490.48 / $520.19	Facility	AS	$209.09	$490.48	$520.19
Providence Facility/Professional Facility Modifier Low / Median / High Price $975.10 / $1,287.35 / $1,831.13	Facility		$975.10	$1,287.35	$1,831.13
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $959.49 / $959.49 / $959.49	Facility	52	$959.49	$959.49	$959.49
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $410.24 / $410.24 / $410.24	Facility	80	$410.24	$410.24	$410.24
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $119.94 / $119.94 / $348.70	Facility	AS	$119.94	$119.94	$348.70
United Facility/Professional Facility Modifier Low / Median / High Price $4,541.00 / $11,228.00 / $25,692.00	Facility		$4,541.00	$11,228.00	$25,692.00