Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,648.60 / $11,564.00 / $25,324.00	Facility		$3,648.60	$11,564.00	$25,324.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $297.11 / $323.44 / $1,824.30	Facility	52	$297.11	$323.44	$1,824.30
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $118.84 / $129.38 / $729.72	Facility	53	$118.84	$129.38	$729.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,204.00 / $15,064.00 / $32,299.00	Facility		$4,204.00	$15,064.00	$32,299.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $15,656.79	Facility		$66.90	$100.00	$15,656.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $9,302.00 / $13,534.00 / $23,091.00	Facility		$9,302.00	$13,534.00	$23,091.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $541.17 / $668.63 / $811.77	Professional		$541.17	$668.63	$811.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $601.77 / $761.15 / $1,428.74	Professional		$601.77	$761.15	$1,428.74
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,385.96 / $31,754.00 / $31,754.00	Facility		$5,385.96	$31,754.00	$31,754.00
Lucent Health Facility/Professional Facility Modifier 52 Low / Median / High Price $758.99 / $25,403.20 / $25,403.20	Facility	52	$758.99	$25,403.20	$25,403.20
Lucent Health Facility/Professional Facility Modifier 53 Low / Median / High Price $189.75 / $6,350.80 / $6,350.80	Facility	53	$189.75	$6,350.80	$6,350.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $641.26 / $875.38 / $18,892.00	Facility		$641.26	$875.38	$18,892.00
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $14,315.00 / $32,191.00	Facility		$7,212.00	$14,315.00	$32,191.00