Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,641.38 / $10,321.00 / $22,788.00	Facility		$2,641.38	$10,321.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,612.00 / $11,825.00 / $22,417.00	Facility		$3,612.00	$11,825.00	$22,417.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $8,389.08	Facility		$63.50	$100.00	$8,389.08
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,265.08 / $1,914.43 / $3,173.80	Professional		$1,265.08	$1,914.43	$3,173.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,368.63 / $3,054.59 / $6,344.60	Professional		$2,368.63	$3,054.59	$6,344.60
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 / $25,012.68 / $30,932.44	Facility		$55.00	$25,012.68	$30,932.44
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,969.36 / $6,964.51 / $7,386.49	Facility	62	$2,969.36	$6,964.51	$7,386.49
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $475.10 / $1,114.32 / $1,181.83	Facility	AS	$475.10	$1,114.32	$1,181.83
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,437.23 / $3,009.34 / $4,105.33	Facility		$2,437.23	$3,009.34	$4,105.33
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $3,624.04 / $3,624.04 / $3,624.04	Facility	62	$3,624.04	$3,624.04	$3,624.04
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $927.75 / $927.75 / $927.75	Facility	80	$927.75	$927.75	$927.75
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $788.59 / $788.59 / $788.59	Facility	AS	$788.59	$788.59	$788.59
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