Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,387.00 / $10,289.00 / $22,788.00	Facility		$2,387.00	$10,289.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,619.00 / $8,484.00 / $18,150.00	Facility		$2,619.00	$8,484.00	$18,150.00
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 $121.95 / $121.95 / $121.95	Facility	AS	$121.95	$121.95	$121.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $611.32 / $925.10 / $1,524.56	Professional		$611.32	$925.10	$1,524.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $996.71 / $1,299.30 / $2,391.19	Professional		$996.71	$1,299.30	$2,391.19
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $134.32 / $169.40 / $500.00	Professional	80	$134.32	$169.40	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $134.32 / $134.32 / $169.40	Professional	AS	$134.32	$134.32	$169.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $9,838.64 / $10,063.84	Facility		$55.00	$9,838.64	$10,063.84
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $212.51 / $497.90 / $526.04	Facility	AS	$212.51	$497.90	$526.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,039.44 / $1,339.17 / $1,827.29	Facility		$1,039.44	$1,339.17	$1,827.29
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $418.20 / $418.20 / $418.20	Facility	80	$418.20	$418.20	$418.20
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $121.95 / $121.95 / $355.47	Facility	AS	$121.95	$121.95	$355.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $4,675.00 / $20,279.00	Facility		$1,204.00	$4,675.00	$20,279.00