Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,696.00 / $11,420.00 / $23,448.77	Facility		$3,696.00	$11,420.00	$23,448.77
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $5,696.00 / $5,696.00 / $15,651.00	Facility	22	$5,696.00	$5,696.00	$15,651.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,390.45 / $13,534.28 / $25,499.40	Facility	50	$3,390.45	$13,534.28	$25,499.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $8,484.00 / $18,150.00	Facility		$1,800.00	$8,484.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $100.00 / $16,016.50	Facility		$69.80	$100.00	$16,016.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $4,270.41 / $13,360.00	Facility		$750.00	$4,270.41	$13,360.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $63.83	Facility	AS	$63.83	$63.83	$63.83
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $322.77 / $634.79 / $856.98	Professional		$322.77	$634.79	$856.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $531.07 / $693.04 / $1,277.47	Professional		$531.07	$693.04	$1,277.47
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $70.84 / $70.84 / $500.00	Professional	80	$70.84	$70.84	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $70.84 / $70.84 / $70.84	Professional	AS	$70.84	$70.84	$70.84
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,722.81 / $16,223.75 / $26,542.00	Facility		$3,722.81	$16,223.75	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $126.10 / $1,537.78 / $1,537.78	Facility	AS	$126.10	$1,537.78	$1,537.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $551.54 / $717.02 / $1,142.64	Facility		$551.54	$717.02	$1,142.64
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $217.26 / $217.26 / $217.26	Facility	80	$217.26	$217.26	$217.26
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $184.67	Facility	AS	$63.83	$63.83	$184.67
United Facility/Professional Facility Modifier Low / Median / High Price $4,578.00 / $13,078.00 / $29,312.00	Facility		$4,578.00	$13,078.00	$29,312.00