Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,169.00 / $5,382.00 / $17,013.00	Facility		$1,169.00	$5,382.00	$17,013.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,616.00 / $9,557.00 / $18,150.00	Facility		$2,616.00	$9,557.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $2,102.15	Facility		$64.40	$100.00	$2,102.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,980.00 / $5,980.00 / $5,980.00	Facility		$5,980.00	$5,980.00	$5,980.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $160.09 / $238.14 / $297.68	Professional		$160.09	$238.14	$297.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.11 / $282.75 / $505.08	Professional		$205.11	$282.75	$505.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,990.54 / $3,569.02 / $5,000.00	Facility		$2,990.54	$3,569.02	$5,000.00
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $277.52 / $650.92 / $676.58	Facility	62	$277.52	$650.92	$676.58
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $44.41 / $104.15 / $108.25	Facility	AS	$44.41	$104.15	$108.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $217.50 / $273.48 / $361.46	Facility		$217.50	$273.48	$361.46
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $159.84 / $159.84 / $286.07	Facility	62	$159.84	$159.84	$286.07
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $73.23 / $73.23 / $73.23	Facility	80	$73.23	$73.23	$73.23
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $25.58 / $25.58 / $62.25	Facility	AS	$25.58	$25.58	$62.25
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,814.00 / $14,315.00	Facility		$587.00	$1,814.00	$14,315.00