Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,546.09 / $9,743.00 / $21,960.90	Facility		$3,546.09	$9,743.00	$21,960.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,022.00 / $10,869.95 / $24,548.00	Facility		$3,022.00	$10,869.95	$24,548.00
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 / $1,576.70 / $13,577.00	Facility		$633.00	$1,576.70	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $154.72 / $154.72 / $154.72	Facility	AS	$154.72	$154.72	$154.72
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $960.91 / $1,454.14 / $1,938.82	Professional		$960.91	$1,454.14	$1,938.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,265.91 / $1,650.50 / $3,042.58	Professional		$1,265.91	$1,650.50	$3,042.58
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $211.32 / $266.49 / $500.00	Professional	80	$211.32	$266.49	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $211.32 / $211.32 / $266.49	Professional	AS	$211.32	$211.32	$266.49
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $10,307.04 / $12,778.64	Facility		$2,800.00	$10,307.04	$12,778.64
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $269.50 / $631.41 / $668.12	Facility	AS	$269.50	$631.41	$668.12
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,320.40 / $1,687.88 / $2,404.30	Facility		$1,320.40	$1,687.88	$2,404.30
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $529.98 / $529.98 / $529.98	Facility	80	$529.98	$529.98	$529.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $154.72 / $154.72 / $450.48	Facility	AS	$154.72	$154.72	$450.48
United Facility/Professional Facility Modifier Low / Median / High Price $3,483.00 / $12,186.00 / $26,672.00	Facility		$3,483.00	$12,186.00	$26,672.00