Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,753.90 / $9,913.64 / $22,788.00	Facility		$1,753.90	$9,913.64	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $9,624.00 / $20,634.00	Facility		$2,143.00	$9,624.00	$20,634.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $64.40 / $100.00 / $21,917.85	Facility		$64.40	$100.00	$21,917.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,973.23 / $14,932.00	Facility		$633.00	$1,973.23	$14,932.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $193.42 / $193.42 / $193.42	Facility	AS	$193.42	$193.42	$193.42
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,039.08 / $1,572.44 / $2,425.46	Professional		$1,039.08	$1,572.44	$2,425.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,581.43 / $2,064.54 / $3,801.67	Professional		$1,581.43	$2,064.54	$3,801.67
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $228.51 / $288.18 / $500.00	Professional	80	$228.51	$288.18	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $228.51 / $228.51 / $288.18	Professional	AS	$228.51	$228.51	$288.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $12,834.08 / $16,005.52	Facility		$2,800.00	$12,834.08	$16,005.52
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $336.18 / $787.03 / $834.64	Facility	AS	$336.18	$787.03	$834.64
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,566.07 / $2,064.42 / $2,985.18	Facility		$1,566.07	$2,064.42	$2,985.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $663.60 / $663.60 / $663.60	Facility	80	$663.60	$663.60	$663.60
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $193.42 / $193.42 / $564.05	Facility	AS	$193.42	$193.42	$564.05
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