Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,291.19 / $10,051.00 / $22,788.00	Facility		$1,291.19	$10,051.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,022.00 / $12,386.00 / $34,573.00	Facility		$3,022.00	$12,386.00	$34,573.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $13,858.12	Facility		$63.90	$100.00	$13,858.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,461.02 / $13,577.00	Facility		$633.00	$1,461.02	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $143.09 / $143.09 / $143.09	Facility	AS	$143.09	$143.09	$143.09
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $860.76 / $1,360.02 / $1,768.03	Professional		$860.76	$1,360.02	$1,768.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,161.58 / $1,514.74 / $2,884.00	Professional		$1,161.58	$1,514.74	$2,884.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $189.20 / $189.20 / $500.00	Professional	80	$189.20	$189.20	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $189.20 / $189.20 / $189.20	Professional	AS	$189.20	$189.20	$189.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $11,510.80 / $11,792.32	Facility		$55.00	$11,510.80	$11,792.32
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $249.17 / $583.41 / $613.05	Facility	AS	$249.17	$583.41	$613.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,211.79 / $1,560.14 / $2,242.42	Facility		$1,211.79	$1,560.14	$2,242.42
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $491.05 / $491.05 / $491.05	Facility	80	$491.05	$491.05	$491.05
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $143.09 / $143.09 / $417.39	Facility	AS	$143.09	$143.09	$417.39
United Facility/Professional Facility Modifier Low / Median / High Price $4,169.00 / $13,205.00 / $29,312.00	Facility		$4,169.00	$13,205.00	$29,312.00