Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $8,479.00 / $20,509.00	Facility		$2,700.00	$8,479.00	$20,509.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,700.00 / $9,256.00 / $19,696.00	Facility		$1,700.00	$9,256.00	$19,696.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $8,208.49	Facility		$67.90	$100.00	$8,208.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $643.00 / $1,047.98 / $13,577.00	Facility		$643.00	$1,047.98	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $102.97 / $102.97 / $102.97	Facility	AS	$102.97	$102.97	$102.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $679.82 / $995.63 / $1,294.32	Professional		$679.82	$995.63	$1,294.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $844.31 / $1,099.84 / $2,084.27	Professional		$844.31	$1,099.84	$2,084.27
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $149.47 / $188.51 / $500.00	Professional	80	$149.47	$188.51	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $149.47 / $149.47 / $188.51	Professional	AS	$149.47	$149.47	$188.51
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $6,871.36 / $13,486.75	Facility		$2,800.00	$6,871.36	$13,486.75
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $202.78 / $1,279.44 / $1,279.44	Facility	AS	$202.78	$1,279.44	$1,279.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $876.31 / $1,125.74 / $1,611.82	Facility		$876.31	$1,125.74	$1,611.82
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $352.42 / $352.42 / $352.42	Facility	80	$352.42	$352.42	$352.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $102.97 / $102.97 / $299.56	Facility	AS	$102.97	$102.97	$299.56
United Facility/Professional Facility Modifier Low / Median / High Price $4,169.00 / $13,245.00 / $29,571.00	Facility		$4,169.00	$13,245.00	$29,571.00