Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,329.00 / $12,524.00 / $44,084.00	Facility		$4,329.00	$12,524.00	$44,084.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,089.46 / $3,089.46 / $4,762.00	Facility	22	$3,089.46	$3,089.46	$4,762.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,738.00 / $12,360.00 / $24,456.00	Facility		$3,738.00	$12,360.00	$24,456.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $12,897.90	Facility		$66.70	$100.00	$12,897.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,185.09 / $12,122.00 / $14,932.00	Facility		$6,185.09	$12,122.00	$14,932.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $956.65 / $1,351.37 / $1,824.35	Professional		$956.65	$1,351.37	$1,824.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,216.23 / $1,555.19 / $2,767.17	Professional		$1,216.23	$1,555.19	$2,767.17
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 $5,897.00 / $5,897.00 / $27,770.10	Facility		$5,897.00	$5,897.00	$27,770.10
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $274.57 / $2,632.21 / $2,632.21	Facility	AS	$274.57	$2,632.21	$2,632.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,233.79 / $1,621.64 / $2,367.38	Facility		$1,233.79	$1,621.64	$2,367.38
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $464.46 / $464.46 / $464.46	Facility	80	$464.46	$464.46	$464.46
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $394.79 / $394.79 / $394.79	Facility	AS	$394.79	$394.79	$394.79
United Facility/Professional Facility Modifier Low / Median / High Price $7,696.00 / $13,722.00 / $29,571.00	Facility		$7,696.00	$13,722.00	$29,571.00