Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,424.32 / $9,639.00 / $20,509.00	Facility		$1,424.32	$9,639.00	$20,509.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,446.00 / $10,450.00 / $21,131.00	Facility		$4,446.00	$10,450.00	$21,131.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $5,485.17	Facility		$63.50	$100.00	$5,485.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,038.72 / $1,400.72 / $1,680.86	Professional		$1,038.72	$1,400.72	$1,680.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,260.65 / $1,614.78 / $2,932.52	Professional		$1,260.65	$1,614.78	$2,932.52
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 / $9,391.84 / $11,858.00	Facility		$55.00	$9,391.84	$11,858.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,550.48 / $3,618.02 / $3,884.04	Facility	62	$1,550.48	$3,618.02	$3,884.04
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $248.08 / $578.88 / $621.45	Facility	AS	$248.08	$578.88	$621.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,345.65 / $1,748.00 / $2,473.28	Facility		$1,345.65	$1,748.00	$2,473.28
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $1,877.01 / $1,877.01 / $1,877.01	Facility	62	$1,877.01	$1,877.01	$1,877.01
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $480.52 / $480.52 / $480.52	Facility	80	$480.52	$480.52	$480.52
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $408.44 / $408.44 / $408.44	Facility	AS	$408.44	$408.44	$408.44
United Facility/Professional Facility Modifier Low / Median / High Price $2,047.00 / $5,067.00 / $20,279.00	Facility		$2,047.00	$5,067.00	$20,279.00