Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,216.00 / $11,769.00 / $32,447.80	Facility		$3,216.00	$11,769.00	$32,447.80
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,500.00 / $8,484.00 / $18,150.00	Facility		$1,500.00	$8,484.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $14,865.02	Facility		$67.90	$100.00	$14,865.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $3,685.47 / $10,261.32	Facility		$750.00	$3,685.47	$10,261.32
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $118.93 / $118.93 / $118.93	Facility	AS	$118.93	$118.93	$118.93
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $611.32 / $1,204.90 / $1,626.62	Professional		$611.32	$1,204.90	$1,626.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $998.90 / $1,309.52 / $2,483.31	Professional		$998.90	$1,309.52	$2,483.31
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 $5,888.46 / $16,547.20 / $26,542.00	Facility		$5,888.46	$16,547.20	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $241.69 / $1,568.44 / $1,568.44	Facility	AS	$241.69	$1,568.44	$1,568.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,054.96 / $1,391.91 / $2,083.35	Facility		$1,054.96	$1,391.91	$2,083.35
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $402.14 / $402.14 / $402.14	Facility	80	$402.14	$402.14	$402.14
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $118.93 / $118.93 / $341.82	Facility	AS	$118.93	$118.93	$341.82
United Facility/Professional Facility Modifier Low / Median / High Price $2,673.00 / $11,228.00 / $26,109.00	Facility		$2,673.00	$11,228.00	$26,109.00