Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,843.00 / $9,697.00 / $19,860.00	Facility		$2,843.00	$9,697.00	$19,860.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $121.93 / $130.79 / $130.79	Facility	53	$121.93	$130.79	$130.79
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $457.25 / $490.46 / $490.46	Facility	54	$457.25	$490.46	$490.46
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $91.45 / $98.09 / $98.09	Facility	55	$91.45	$98.09	$98.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $570.54 / $670.63 / $1,159.58	Professional		$570.54	$670.63	$1,159.58
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $87.74 / $98.09 / $200.46	Professional	55	$87.74	$98.09	$200.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $618.66 / $669.33 / $773.88	Professional		$618.66	$669.33	$773.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,619.00 / $11,400.00 / $21,514.00	Facility		$4,619.00	$11,400.00	$21,514.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $781.75 / $998.43 / $1,965.83	Professional		$781.75	$998.43	$1,965.83
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $5,175.10	Facility		$66.09	$100.00	$5,175.10
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $493.33 / $752.68 / $1,450.66	Professional		$493.33	$752.68	$1,450.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $5,345.41 / $7,286.11	Facility		$705.31	$5,345.41	$7,286.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $662.36 / $895.44 / $1,817.59	Professional		$662.36	$895.44	$1,817.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $594.19 / $810.57 / $5,271.29	Professional		$594.19	$810.57	$5,271.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $638.05 / $848.62 / $1,599.55	Professional		$638.05	$848.62	$1,599.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,714.36 / $21,325.00	Facility		$55.00	$3,714.36	$21,325.00
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $314.68 / $4,042.62 / $4,042.62	Facility	53	$314.68	$4,042.62	$4,042.62
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $1,101.39 / $14,149.17 / $14,149.17	Facility	54	$1,101.39	$14,149.17	$14,149.17
Lucent Health Facility/Professional Facility Modifier 55 Low / Median / High Price $236.01 / $3,031.96 / $3,031.96	Facility	55	$236.01	$3,031.96	$3,031.96
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $4,949.35 / $5,089.60 / $5,600.48	Professional		$4,949.35	$5,089.60	$5,600.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $705.31 / $871.83 / $1,297.83	Facility		$705.31	$871.83	$1,297.83
Providence Facility/Professional Facility Modifier 54 Low / Median / High Price $1,268.74 / $1,268.74 / $1,268.74	Facility	54	$1,268.74	$1,268.74	$1,268.74
Providence Facility/Professional Facility Modifier 55 Low / Median / High Price $317.19 / $317.19 / $317.19	Facility	55	$317.19	$317.19	$317.19
Providence Facility/Professional Professional Modifier Low / Median / High Price $689.50 / $954.84 / $1,876.25	Professional		$689.50	$954.84	$1,876.25
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $250.83 / $312.45 / $375.25	Professional	55	$250.83	$312.45	$375.25
The Alliance Facility/Professional Professional Modifier Low / Median / High Price $655.15 / $772.45 / $1,010.12	Professional		$655.15	$772.45	$1,010.12
United Facility/Professional Facility Modifier Low / Median / High Price $6,323.14 / $11,420.00 / $24,268.00	Facility		$6,323.14	$11,420.00	$24,268.00
United Facility/Professional Professional Modifier Low / Median / High Price $548.83 / $722.32 / $1,756.37	Professional		$548.83	$722.32	$1,756.37