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 $2,675.00 / $10,474.00 / $23,548.00	Facility		$2,675.00	$10,474.00	$23,548.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $7,680.36	Facility		$66.70	$100.00	$7,680.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,231.67 / $13,577.00	Facility		$633.00	$1,231.67	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $121.47 / $121.47 / $121.47	Facility	AS	$121.47	$121.47	$121.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $794.49 / $1,202.29 / $1,571.43	Professional		$794.49	$1,202.29	$1,571.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,010.09 / $1,320.68 / $2,396.42	Professional		$1,010.09	$1,320.68	$2,396.42
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $174.87 / $220.53 / $500.00	Professional	80	$174.87	$220.53	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $174.87 / $174.87 / $220.53	Professional	AS	$174.87	$174.87	$220.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $8,044.24 / $10,098.16	Facility		$2,800.00	$8,044.24	$10,098.16
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $210.89 / $494.71 / $533.10	Facility	AS	$210.89	$494.71	$533.10
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,031.69 / $1,346.78 / $1,950.46	Facility		$1,031.69	$1,346.78	$1,950.46
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $416.40 / $416.40 / $416.40	Facility	80	$416.40	$416.40	$416.40
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $121.47 / $121.47 / $353.94	Facility	AS	$121.47	$121.47	$353.94
United Facility/Professional Facility Modifier Low / Median / High Price $1,671.00 / $6,108.00 / $18,709.00	Facility		$1,671.00	$6,108.00	$18,709.00