Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,117.54 / $10,321.00 / $22,788.00	Facility		$2,117.54	$10,321.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $8,947.00 / $19,298.00	Facility		$2,873.70	$8,947.00	$19,298.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $8,393.26	Facility		$63.90	$100.00	$8,393.26
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 $233.27 / $233.27 / $233.27	Facility	AS	$233.27	$233.27	$233.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,155.25 / $1,748.23 / $2,940.37	Professional		$1,155.25	$1,748.23	$2,940.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,913.52 / $2,496.42 / $4,644.00	Professional		$1,913.52	$2,496.42	$4,644.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $255.13 / $321.75 / $500.00	Professional	80	$255.13	$321.75	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $255.13 / $255.13 / $321.75	Professional	AS	$255.13	$255.13	$321.75
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $18,836.48 / $19,310.88	Facility		$55.00	$18,836.48	$19,310.88
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $405.78 / $950.53 / $1,009.91	Facility	AS	$405.78	$950.53	$1,009.91
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,955.55 / $2,489.83 / $3,508.11	Facility		$1,955.55	$2,489.83	$3,508.11
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $799.92 / $799.92 / $799.92	Facility	80	$799.92	$799.92	$799.92
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $233.27 / $233.27 / $679.93	Facility	AS	$233.27	$233.27	$679.93
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