Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,340.00 / $9,919.00 / $22,788.00	Facility		$1,340.00	$9,919.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,448.41 / $8,573.74 / $26,633.44	Facility		$1,448.41	$8,573.74	$26,633.44
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 / $1,512.50 / $13,577.00	Facility		$633.00	$1,512.50	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $148.22 / $148.22 / $148.22	Facility	AS	$148.22	$148.22	$148.22
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,004.84 / $1,438.64 / $1,870.23	Professional		$1,004.84	$1,438.64	$1,870.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,217.55 / $1,590.06 / $3,017.35	Professional		$1,217.55	$1,590.06	$3,017.35
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $221.14 / $221.14 / $500.00	Professional	80	$221.14	$221.14	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $221.14 / $221.14 / $221.14	Professional	AS	$221.14	$221.14	$221.14
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $10,160.00 / $12,283.84	Facility		$2,800.00	$10,160.00	$12,283.84
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $258.36 / $604.77 / $642.59	Facility	AS	$258.36	$604.77	$642.59
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,272.05 / $1,653.67 / $2,307.94	Facility		$1,272.05	$1,653.67	$2,307.94
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $508.14 / $508.14 / $508.14	Facility	80	$508.14	$508.14	$508.14
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $148.22 / $148.22 / $431.92	Facility	AS	$148.22	$148.22	$431.92
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