Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,017.00 / $5,068.00 / $17,054.00	Facility		$1,017.00	$5,068.00	$17,054.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,537.00 / $9,596.00 / $18,150.00	Facility		$3,537.00	$9,596.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,455.40	Facility		$63.90	$100.00	$5,455.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $409.90 / $620.29 / $990.19	Professional		$409.90	$620.29	$990.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $677.12 / $922.51 / $1,705.00	Professional		$677.12	$922.51	$1,705.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,500.00 / $9,965.34 / $12,164.88	Facility		$5,500.00	$9,965.34	$12,164.88
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $924.46 / $2,168.54 / $2,252.01	Facility	62	$924.46	$2,168.54	$2,252.01
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $147.91 / $346.97 / $360.32	Facility	AS	$147.91	$346.97	$360.32
Providence Facility/Professional Facility Modifier Low / Median / High Price $790.29 / $959.17 / $1,540.94	Facility		$790.29	$959.17	$1,540.94
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $531.50 / $531.50 / $1,129.22	Facility	62	$531.50	$531.50	$1,129.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $289.08 / $289.08 / $289.08	Facility	80	$289.08	$289.08	$289.08
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $85.04 / $85.04 / $245.72	Facility	AS	$85.04	$85.04	$245.72
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,572.00 / $9,132.00	Facility		$587.00	$1,572.00	$9,132.00