Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,624.00 / $9,821.00 / $22,788.00	Facility		$3,624.00	$9,821.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $11,233.00 / $24,057.00	Facility		$2,143.00	$11,233.00	$24,057.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $20,774.09	Facility		$67.90	$100.00	$20,774.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $716.00 / $1,227.70 / $14,932.00	Facility		$716.00	$1,227.70	$14,932.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $120.50 / $120.50 / $120.50	Facility	AS	$120.50	$120.50	$120.50
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $801.19 / $1,155.71 / $1,515.54	Professional		$801.19	$1,155.71	$1,515.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $983.22 / $1,281.05 / $2,430.41	Professional		$983.22	$1,281.05	$2,430.41
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $176.10 / $222.08 / $500.00	Professional	80	$176.10	$222.08	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $176.10 / $176.10 / $222.08	Professional	AS	$176.10	$176.10	$222.08
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $10,160.00 / $22,189.40	Facility		$2,800.00	$10,160.00	$22,189.40
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $237.15 / $2,105.03 / $2,105.03	Facility	AS	$237.15	$2,105.03	$2,105.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,026.30 / $1,346.15 / $2,068.85	Facility		$1,026.30	$1,346.15	$2,068.85
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $413.06 / $413.06 / $413.06	Facility	80	$413.06	$413.06	$413.06
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $120.50 / $120.50 / $351.10	Facility	AS	$120.50	$120.50	$351.10
United Facility/Professional Facility Modifier Low / Median / High Price $4,578.00 / $13,407.00 / $29,312.00	Facility		$4,578.00	$13,407.00	$29,312.00