Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,089.46 / $9,833.00 / $21,479.00	Facility		$3,089.46	$9,833.00	$21,479.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $570.83 / $610.22 / $610.22	Facility	54	$570.83	$610.22	$610.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.37 / $941.74 / $1,392.04	Professional		$731.37	$941.74	$1,392.04
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $109.56 / $122.04 / $251.09	Professional	55	$109.56	$122.04	$251.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $10,905.00 / $21,514.00	Facility		$2,456.00	$10,905.00	$21,514.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $975.58 / $1,248.41 / $2,453.75	Professional		$975.58	$1,248.41	$2,453.75
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $6,840.83	Facility		$66.09	$100.00	$6,840.83
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $616.80 / $939.63 / $1,813.78	Professional		$616.80	$939.63	$1,813.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $5,349.93 / $7,292.27	Facility		$705.31	$5,349.93	$7,292.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $827.96 / $1,114.08 / $2,259.63	Professional		$827.96	$1,114.08	$2,259.63
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $741.99 / $1,004.70 / $5,275.75	Professional		$741.99	$1,004.70	$5,275.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.07 / $1,055.18 / $1,989.72	Professional		$794.07	$1,055.18	$1,989.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,639.43 / $21,343.05	Facility		$55.00	$4,639.43	$21,343.05
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,375.68 / $14,161.14 / $14,161.14	Facility	54	$1,375.68	$14,161.14	$14,161.14
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $6,188.96 / $6,370.48 / $6,982.88	Professional		$6,188.96	$6,370.48	$6,982.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $876.45 / $1,085.30 / $1,608.70	Facility		$876.45	$1,085.30	$1,608.70
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,589.94 / $1,589.94 / $1,589.94	Facility	54	$1,589.94	$1,589.94	$1,589.94
Providence Facility/Professional Professional Modifier Low / Median / High Price $859.26 / $1,193.81 / $2,351.25	Professional		$859.26	$1,193.81	$2,351.25
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $314.33 / $391.55 / $470.25	Professional	55	$314.33	$391.55	$470.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $812.02 / $964.59 / $1,261.39	Professional		$812.02	$964.59	$1,261.39
United Facility/Professional Facility Modifier Low / Median / High Price $5,478.00 / $12,313.00 / $26,451.00	Facility		$5,478.00	$12,313.00	$26,451.00
United Facility/Professional Professional Modifier Low / Median / High Price $693.00 / $921.73 / $2,366.41	Professional		$693.00	$921.73	$2,366.41