Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,953.00 / $10,443.00 / $25,328.00	Facility		$2,953.00	$10,443.00	$25,328.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $8,662.34 / $8,662.34 / $8,662.34	Facility	22	$8,662.34	$8,662.34	$8,662.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,822.00 / $10,424.00 / $19,888.00	Facility		$2,822.00	$10,424.00	$19,888.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.59 / $100.00 / $10,063.87	Facility		$67.59	$100.00	$10,063.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $717.60 / $4,807.33 / $33,435.00	Facility		$717.60	$4,807.33	$33,435.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $107.75 / $107.75 / $107.75	Facility	AS	$107.75	$107.75	$107.75
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $707.74 / $1,041.24 / $2,629.98	Professional		$707.74	$1,041.24	$2,629.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $910.18 / $1,155.13 / $2,182.71	Professional		$910.18	$1,155.13	$2,182.71
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $155.62 / $196.25 / $500.00	Professional	80	$155.62	$196.25	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $155.62 / $155.62 / $196.25	Professional	AS	$155.62	$155.62	$196.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $4,400.00 / $13,044.12 / $14,630.00	Facility		$4,400.00	$13,044.12	$14,630.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $211.41 / $1,008.48 / $1,008.48	Facility	AS	$211.41	$1,008.48	$1,008.48
Providence Facility/Professional Facility Modifier Low / Median / High Price $916.13 / $1,183.20 / $1,849.52	Facility		$916.13	$1,183.20	$1,849.52
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $368.87 / $368.87 / $368.87	Facility	80	$368.87	$368.87	$368.87
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $107.75 / $107.75 / $313.54	Facility	AS	$107.75	$107.75	$313.54
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $29,585.00 / $29,585.00 / $29,585.00	Facility		$29,585.00	$29,585.00	$29,585.00
United Facility/Professional Facility Modifier Low / Median / High Price $6,356.00 / $15,425.00 / $36,792.00	Facility		$6,356.00	$15,425.00	$36,792.00