Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,294.68 / $9,674.00 / $22,788.00	Facility		$1,294.68	$9,674.00	$22,788.00
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 $146.97 / $146.97 / $146.97	Facility	AS	$146.97	$146.97	$146.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $602.75 / $912.14 / $1,846.16	Professional		$602.75	$912.14	$1,846.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,204.83 / $1,570.48 / $2,895.82	Professional		$1,204.83	$1,570.48	$2,895.82
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $132.69 / $167.33 / $500.00	Professional	80	$132.69	$167.33	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $132.69 / $132.69 / $167.33	Professional	AS	$132.69	$132.69	$167.33
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $11,876.96 / $12,136.96	Facility		$55.00	$11,876.96	$12,136.96
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $256.33 / $600.67 / $635.88	Facility	AS	$256.33	$600.67	$635.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,117.48 / $1,560.19 / $2,160.51	Facility		$1,117.48	$1,560.19	$2,160.51
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $503.13 / $503.13 / $503.13	Facility	80	$503.13	$503.13	$503.13
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $146.97 / $146.97 / $427.66	Facility	AS	$146.97	$146.97	$427.66
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