Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,174.00 / $5,484.52 / $17,380.00	Facility		$1,174.00	$5,484.52	$17,380.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $492.33 / $7,471.00 / $19,038.00	Facility		$492.33	$7,471.00	$19,038.00
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 $625.09 / $945.95 / $1,291.08	Professional		$625.09	$945.95	$1,291.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $870.63 / $1,199.21 / $2,198.02	Professional		$870.63	$1,199.21	$2,198.02
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $12,848.78 / $15,715.42	Facility		$5,000.00	$12,848.78	$15,715.42
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $191.12 / $448.09 / $467.81	Facility	AS	$191.12	$448.09	$467.81
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,020.99 / $1,247.69 / $1,927.75	Facility		$1,020.99	$1,247.69	$1,927.75
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $372.85 / $372.85 / $372.85	Facility	80	$372.85	$372.85	$372.85
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $109.42 / $109.42 / $316.92	Facility	AS	$109.42	$109.42	$316.92
United Facility/Professional Facility Modifier Low / Median / High Price $587.00 / $1,551.00 / $7,935.00	Facility		$587.00	$1,551.00	$7,935.00