Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,337.53 / $9,674.00 / $22,788.00	Facility		$1,337.53	$9,674.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,043.00 / $11,055.00 / $22,831.47	Facility		$4,043.00	$11,055.00	$22,831.47
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.09 / $100.00 / $5,367.09	Facility		$66.09	$100.00	$5,367.09
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 $152.11 / $152.11 / $152.11	Facility	AS	$152.11	$152.11	$152.11
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $548.03 / $829.32 / $1,901.30	Professional		$548.03	$829.32	$1,901.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,243.20 / $1,619.88 / $2,980.57	Professional		$1,243.20	$1,619.88	$2,980.57
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $120.41 / $151.83 / $500.00	Professional	80	$120.41	$151.83	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $120.41 / $120.41 / $151.83	Professional	AS	$120.41	$120.41	$151.83
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $12,268.80 / $12,545.84	Facility		$55.00	$12,268.80	$12,545.84
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $265.08 / $621.27 / $656.13	Facility	AS	$265.08	$621.27	$656.13
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,153.44 / $1,608.90 / $2,225.34	Facility		$1,153.44	$1,608.90	$2,225.34
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $520.99 / $520.99 / $520.99	Facility	80	$520.99	$520.99	$520.99
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $152.11 / $152.11 / $442.84	Facility	AS	$152.11	$152.11	$442.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,692.00 / $9,451.00 / $21,278.00	Facility		$1,692.00	$9,451.00	$21,278.00