Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,063.82 / $9,674.00 / $22,788.00	Facility		$1,063.82	$9,674.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $8,947.00 / $19,298.00	Facility		$2,873.70	$8,947.00	$19,298.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $5,487.90	Facility		$63.90	$100.00	$5,487.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $766.00 / $5,431.00	Facility		$633.00	$766.00	$5,431.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $128.44 / $128.44 / $128.44	Facility	AS	$128.44	$128.44	$128.44
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $611.32 / $925.10 / $1,603.98	Professional		$611.32	$925.10	$1,603.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,049.19 / $1,367.99 / $2,529.00	Professional		$1,049.19	$1,367.99	$2,529.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $134.32 / $169.40 / $500.00	Professional	80	$134.32	$169.40	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $134.32 / $134.32 / $169.40	Professional	AS	$134.32	$134.32	$169.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $10,362.40 / $10,601.20	Facility		$55.00	$10,362.40	$10,601.20
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $223.86 / $524.39 / $553.74	Facility	AS	$223.86	$524.39	$553.74
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,045.02 / $1,373.32 / $1,988.88	Facility		$1,045.02	$1,373.32	$1,988.88
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $440.04 / $440.04 / $440.04	Facility	80	$440.04	$440.04	$440.04
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $128.44 / $128.44 / $374.04	Facility	AS	$128.44	$128.44	$374.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $4,675.00 / $20,279.00	Facility		$1,204.00	$4,675.00	$20,279.00