Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $8,598.23 / $20,509.00	Facility		$2,700.00	$8,598.23	$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 $63.90 / $100.00 / $13,858.12	Facility		$63.90	$100.00	$13,858.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,372.04 / $13,577.00	Facility		$633.00	$1,372.04	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $135.26 / $135.26 / $135.26	Facility	AS	$135.26	$135.26	$135.26
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $870.44 / $1,317.23 / $1,732.08	Professional		$870.44	$1,317.23	$1,732.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,118.39 / $1,460.16 / $2,770.01	Professional		$1,118.39	$1,460.16	$2,770.01
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $191.66 / $241.70 / $500.00	Professional	80	$191.66	$241.70	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $191.66 / $191.66 / $241.70	Professional	AS	$191.66	$191.66	$241.70
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $8,971.52 / $11,212.80	Facility		$2,800.00	$8,971.52	$11,212.80
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $234.79 / $550.88 / $590.26	Facility	AS	$234.79	$550.88	$590.26
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,147.07 / $1,491.18 / $2,149.10	Facility		$1,147.07	$1,491.18	$2,149.10
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $464.20 / $464.20 / $464.20	Facility	80	$464.20	$464.20	$464.20
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $135.26 / $135.26 / $394.57	Facility	AS	$135.26	$135.26	$394.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,055.00 / $4,820.00 / $20,279.00	Facility		$1,055.00	$4,820.00	$20,279.00