Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $9,833.00 / $21,479.00	Facility		$2,421.00	$9,833.00	$21,479.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,675.00 / $8,805.92 / $18,758.00	Facility		$2,675.00	$8,805.92	$18,758.00
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 $104.84 / $104.84 / $104.84	Facility	AS	$104.84	$104.84	$104.84
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $559.57 / $846.79 / $1,316.61	Professional		$559.57	$846.79	$1,316.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $858.86 / $1,118.75 / $2,058.32	Professional		$858.86	$1,118.75	$2,058.32
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $123.27 / $155.44 / $500.00	Professional	80	$123.27	$155.44	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $123.27 / $123.27 / $155.44	Professional	AS	$123.27	$123.27	$155.44
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $8,459.12 / $8,652.00	Facility		$55.00	$8,459.12	$8,652.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $182.60 / $428.11 / $453.29	Facility	AS	$182.60	$428.11	$453.29
Providence Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $1,145.15 / $1,574.58	Facility		$895.00	$1,145.15	$1,574.58
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $358.72 / $358.72 / $358.72	Facility	80	$358.72	$358.72	$358.72
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $104.84 / $104.84 / $304.91	Facility	AS	$104.84	$104.84	$304.91
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