Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,031.58 / $9,674.00 / $22,788.00	Facility		$1,031.58	$9,674.00	$22,788.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $439.64 / $515.79 / $2,953.27	Facility	52	$439.64	$515.79	$2,953.27
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,619.00 / $8,484.00 / $18,150.00	Facility		$2,619.00	$8,484.00	$18,150.00
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 $931.75 / $931.75 / $931.75	Facility	52	$931.75	$931.75	$931.75
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $116.47 / $116.47 / $116.47	Facility	AS	$116.47	$116.47	$116.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,121.08 / $1,233.20 / $1,513.47	Professional		$1,121.08	$1,233.20	$1,513.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $952.51 / $1,242.45 / $2,289.12	Professional		$952.51	$1,242.45	$2,289.12
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 / $8,225.42 / $8,412.67	Facility		$55.00	$8,225.42	$8,412.67
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,624.10 / $3,805.14 / $4,021.70	Facility	52	$1,624.10	$3,805.14	$4,021.70
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $203.01 / $475.64 / $502.71	Facility	AS	$203.01	$475.64	$502.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $887.78 / $1,230.83 / $1,717.70	Facility		$887.78	$1,230.83	$1,717.70
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $931.75 / $931.75 / $931.75	Facility	52	$931.75	$931.75	$931.75
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $399.06 / $399.06 / $399.06	Facility	80	$399.06	$399.06	$399.06
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $116.47 / $116.47 / $339.20	Facility	AS	$116.47	$116.47	$339.20
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