Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,023.00 / $5,215.12 / $16,713.00	Facility		$1,023.00	$5,215.12	$16,713.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,294.00 / $9,104.00 / $18,679.00	Facility		$3,294.00	$9,104.00	$18,679.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $80.09 / $88.00 / $13,596.00	Facility		$80.09	$88.00	$13,596.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,359.00 / $8,359.00 / $8,359.00	Facility		$8,359.00	$8,359.00	$8,359.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $328.74 / $410.28 / $512.85	Professional		$328.74	$410.28	$512.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.11 / $488.35 / $876.05	Professional		$354.11	$488.35	$876.05
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,000.00 / $5,181.26 / $6,313.44	Facility		$4,000.00	$5,181.26	$6,313.44
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $480.30 / $1,126.85 / $1,168.08	Facility	62	$480.30	$1,126.85	$1,168.08
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $76.84 / $180.30 / $186.89	Facility	AS	$76.84	$180.30	$186.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $382.11 / $474.99 / $645.19	Facility		$382.11	$474.99	$645.19
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $276.13 / $276.13 / $586.69	Facility	62	$276.13	$276.13	$586.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $150.19 / $150.19 / $150.19	Facility	80	$150.19	$150.19	$150.19
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $44.18 / $44.18 / $127.66	Facility	AS	$44.18	$44.18	$127.66
United Facility/Professional Facility Modifier Low / Median / High Price $6,934.00 / $12,446.00 / $26,451.00	Facility		$6,934.00	$12,446.00	$26,451.00