Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $12,617.00 / $30,187.88	Facility		$2,421.00	$12,617.00	$30,187.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,715.59 / $9,000.00 / $25,937.91	Facility		$1,715.59	$9,000.00	$25,937.91
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 $643.00 / $2,151.00 / $13,439.00	Facility		$643.00	$2,151.00	$13,439.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $194.20 / $194.20 / $194.20	Facility	AS	$194.20	$194.20	$194.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $948.25 / $1,793.73 / $2,502.44	Professional		$948.25	$1,793.73	$2,502.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,615.04 / $2,072.78 / $3,921.00	Professional		$1,615.04	$2,072.78	$3,921.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $208.45 / $262.88 / $500.00	Professional	80	$208.45	$262.88	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $208.45 / $208.45 / $262.88	Professional	AS	$208.45	$208.45	$262.88
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,500.00 / $19,431.36 / $23,994.24	Facility		$8,500.00	$19,431.36	$23,994.24
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $338.22 / $792.48 / $834.11	Facility	AS	$338.22	$792.48	$834.11
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,647.42 / $2,141.65 / $3,327.09	Facility		$1,647.42	$2,141.65	$3,327.09
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $665.53 / $665.53 / $665.53	Facility	80	$665.53	$665.53	$665.53
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $194.20 / $194.20 / $565.70	Facility	AS	$194.20	$194.20	$565.70
United Facility/Professional Facility Modifier Low / Median / High Price $6,341.00 / $12,633.00 / $30,330.00	Facility		$6,341.00	$12,633.00	$30,330.00