Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.83 / $10,004.00 / $22,788.00	Facility		$350.83	$10,004.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,097.00 / $6,264.00 / $14,341.00	Facility		$2,097.00	$6,264.00	$14,341.00
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 $401.09 / $750.00 / $5,431.00	Facility		$401.09	$750.00	$5,431.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $243.96 / $243.96 / $243.96	Facility	62	$243.96	$243.96	$243.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $39.03 / $39.03 / $39.03	Facility	AS	$39.03	$39.03	$39.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $315.33 / $365.15 / $492.95	Professional		$315.33	$365.15	$492.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $314.12 / $413.52 / $777.63	Professional		$314.12	$413.52	$777.63
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $69.20 / $87.29 / $500.00	Professional	80	$69.20	$87.29	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $69.20 / $69.20 / $87.29	Professional	AS	$69.20	$69.20	$87.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,453.28 / $1,657.85	Facility		$55.00	$1,453.28	$1,657.85
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $425.07 / $992.48 / $1,036.16	Facility	62	$425.07	$992.48	$1,036.16
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $68.01 / $158.80 / $165.79	Facility	AS	$68.01	$158.80	$165.79
Providence Facility/Professional Facility Modifier Low / Median / High Price $337.09 / $442.60 / $699.61	Facility		$337.09	$442.60	$699.61
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $243.96 / $243.96 / $522.96	Facility	62	$243.96	$243.96	$522.96
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $133.88 / $133.88 / $133.88	Facility	80	$133.88	$133.88	$133.88
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $39.03 / $39.03 / $113.80	Facility	AS	$39.03	$39.03	$113.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,483.00 / $11,707.00 / $26,451.00	Facility		$3,483.00	$11,707.00	$26,451.00