Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,986.84 / $10,321.00 / $22,788.00	Facility		$1,986.84	$10,321.00	$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 $227.05 / $227.05 / $227.05	Facility	AS	$227.05	$227.05	$227.05
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $934.10 / $1,413.58 / $2,807.92	Professional		$934.10	$1,413.58	$2,807.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,845.23 / $2,406.23 / $4,492.00	Professional		$1,845.23	$2,406.23	$4,492.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $205.58 / $259.26 / $500.00	Professional	80	$205.58	$259.26	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $205.58 / $205.58 / $259.26	Professional	AS	$205.58	$205.58	$259.26
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $18,288.64 / $18,705.75	Facility		$55.00	$18,288.64	$18,705.75
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $395.93 / $927.06 / $973.87	Facility	AS	$395.93	$927.06	$973.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,639.90 / $2,372.92 / $3,314.58	Facility		$1,639.90	$2,372.92	$3,314.58
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $777.56 / $777.56 / $777.56	Facility	80	$777.56	$777.56	$777.56
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $227.05 / $227.05 / $660.93	Facility	AS	$227.05	$227.05	$660.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00