Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,762.36 / $10,289.00 / $22,788.00	Facility		$1,762.36	$10,289.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $10,524.00 / $21,623.00	Facility		$2,143.00	$10,524.00	$21,623.00
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 $766.00 / $3,685.47 / $10,261.32	Facility		$766.00	$3,685.47	$10,261.32
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $132.97 / $132.97 / $132.97	Facility	AS	$132.97	$132.97	$132.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $759.12 / $1,343.69 / $1,813.98	Professional		$759.12	$1,343.69	$1,813.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,115.86 / $1,462.50 / $2,774.38	Professional		$1,115.86	$1,462.50	$2,774.38
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $167.09 / $210.72 / $500.00	Professional	80	$167.09	$210.72	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $167.09 / $167.09 / $210.72	Professional	AS	$167.09	$167.09	$210.72
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $6,590.82 / $16,547.20 / $26,542.00	Facility		$6,590.82	$16,547.20	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $270.39 / $1,568.44 / $1,568.44	Facility	AS	$270.39	$1,568.44	$1,568.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,197.13 / $1,611.81 / $2,491.00	Facility		$1,197.13	$1,611.81	$2,491.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $450.71 / $450.71 / $450.71	Facility	80	$450.71	$450.71	$450.71
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $132.97 / $132.97 / $383.10	Facility	AS	$132.97	$132.97	$383.10
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