Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,400.00 / $10,302.00 / $24,098.00	Facility		$3,400.00	$10,302.00	$24,098.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $4,622.00 / $4,622.00 / $4,622.00	Facility	22	$4,622.00	$4,622.00	$4,622.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,122.82 / $14,843.29 / $37,593.00	Facility	50	$5,122.82	$14,843.29	$37,593.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,275.00 / $9,830.00 / $20,634.00	Facility		$3,275.00	$9,830.00	$20,634.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $12,661.13	Facility		$66.70	$100.00	$12,661.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,613.43 / $11,684.00 / $14,696.00	Facility		$3,613.43	$11,684.00	$14,696.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $488.97 / $720.23 / $972.31	Professional		$488.97	$720.23	$972.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $648.21 / $829.66 / $1,480.51	Professional		$648.21	$829.66	$1,480.51
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 $4,230.31 / $16,223.75 / $26,542.00	Facility		$4,230.31	$16,223.75	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $146.93 / $1,537.78 / $1,537.78	Facility	AS	$146.93	$1,537.78	$1,537.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $671.97 / $861.04 / $1,424.43	Facility		$671.97	$861.04	$1,424.43
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $248.99 / $248.99 / $248.99	Facility	80	$248.99	$248.99	$248.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $211.64 / $211.64 / $211.64	Facility	AS	$211.64	$211.64	$211.64
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $13,651.00 / $29,571.00	Facility		$7,212.00	$13,651.00	$29,571.00