Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,681.40 / $11,075.00 / $24,452.82	Facility		$2,681.40	$11,075.00	$24,452.82
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $238.87 / $260.11 / $1,460.04	Facility	52	$238.87	$260.11	$1,460.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $95.55 / $104.04 / $584.01	Facility	53	$95.55	$104.04	$584.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,204.00 / $14,879.00 / $32,242.00	Facility		$4,204.00	$14,879.00	$32,242.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $12,897.90	Facility		$66.09	$100.00	$12,897.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,893.00 / $13,335.00 / $23,091.00	Facility		$6,893.00	$13,335.00	$23,091.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $435.12 / $535.58 / $5,086.82	Professional		$435.12	$535.58	$5,086.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $482.02 / $609.65 / $1,133.92	Professional		$482.02	$609.65	$1,133.92
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,313.88 / $31,754.00 / $31,754.00	Facility		$4,313.88	$31,754.00	$31,754.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $916.51 / $25,403.20 / $25,403.20	Facility	52	$916.51	$25,403.20	$25,403.20
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $229.13 / $6,350.80 / $6,350.80	Facility	53	$229.13	$6,350.80	$6,350.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $513.63 / $703.67 / $18,892.00	Facility		$513.63	$703.67	$18,892.00
United Facility/Professional Facility Modifier Low / Median / High Price $6,385.00 / $14,189.00 / $33,317.00	Facility		$6,385.00	$14,189.00	$33,317.00