Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,696.00 / $10,616.00 / $38,204.43	Facility		$3,696.00	$10,616.00	$38,204.43
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $881.83 / $947.19 / $4,185.68	Facility	52	$881.83	$947.19	$4,185.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,612.00 / $11,723.00 / $22,642.00	Facility		$3,612.00	$11,723.00	$22,642.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $6,007.09	Facility		$66.00	$100.00	$6,007.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,684.00 / $13,360.00 / $14,932.00	Facility		$11,684.00	$13,360.00	$14,932.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $953.09 / $1,314.58 / $1,577.50	Professional		$953.09	$1,314.58	$1,577.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,183.11 / $1,514.74 / $2,729.32	Professional		$1,183.11	$1,514.74	$2,729.32
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 $2,800.00 / $2,800.00 / $22,189.40	Facility		$2,800.00	$2,800.00	$22,189.40
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $2,188.61 / $16,840.24 / $16,840.24	Facility	52	$2,188.61	$16,840.24	$16,840.24
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $1,709.85 / $13,156.44 / $13,156.44	Facility	62	$1,709.85	$13,156.44	$13,156.44
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $273.58 / $2,105.03 / $2,105.03	Facility	AS	$273.58	$2,105.03	$2,105.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,391.58 / $1,855.44 / $2,836.32	Facility		$1,391.58	$1,855.44	$2,836.32
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,109.88 / $2,109.88 / $2,109.88	Facility	62	$2,109.88	$2,109.88	$2,109.88
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $540.13 / $540.13 / $540.13	Facility	80	$540.13	$540.13	$540.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $459.11 / $459.11 / $459.11	Facility	AS	$459.11	$459.11	$459.11
United Facility/Professional Facility Modifier Low / Median / High Price $8,822.00 / $18,315.00 / $45,545.00	Facility		$8,822.00	$18,315.00	$45,545.00