Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,530.35 / $14,353.00 / $25,999.42	Facility		$3,530.35	$14,353.00	$25,999.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,518.00 / $12,766.00 / $25,103.02	Facility		$5,518.00	$12,766.00	$25,103.02
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $100.00 / $15,436.09	Facility		$66.90	$100.00	$15,436.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $664.60 / $13,360.00 / $34,622.00	Facility		$664.60	$13,360.00	$34,622.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $123.14 / $123.14 / $123.14	Facility	AS	$123.14	$123.14	$123.14
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,073.33 / $1,142.04 / $1,610.01	Professional		$1,073.33	$1,142.04	$1,610.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,025.61 / $1,304.58 / $2,463.69	Professional		$1,025.61	$1,304.58	$2,463.69
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $236.30 / $236.30 / $500.00	Professional	80	$236.30	$236.30	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $236.30 / $236.30 / $236.30	Professional	AS	$236.30	$236.30	$236.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $12,334.80 / $14,824.56 / $22,630.00	Facility		$12,334.80	$14,824.56	$22,630.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $214.91 / $502.13 / $521.04	Facility	AS	$214.91	$502.13	$521.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,063.48 / $1,324.91 / $2,063.69	Facility		$1,063.48	$1,324.91	$2,063.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $424.37 / $424.37 / $424.37	Facility	80	$424.37	$424.37	$424.37
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $123.14 / $123.14 / $360.71	Facility	AS	$123.14	$123.14	$360.71
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 $4,169.00 / $13,000.00 / $31,796.00	Facility		$4,169.00	$13,000.00	$31,796.00