Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,822.55 / $10,286.10 / $22,788.00	Facility		$1,822.55	$10,286.10	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,173.34 / $9,624.00 / $20,634.00	Facility		$2,173.34	$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 / $2,052.10 / $14,932.00	Facility		$633.00	$2,052.10	$14,932.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $200.73 / $200.73 / $200.73	Facility	AS	$200.73	$200.73	$200.73
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,264.33 / $1,913.30 / $2,523.27	Professional		$1,264.33	$1,913.30	$2,523.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,644.97 / $2,150.90 / $4,079.44	Professional		$1,644.97	$2,150.90	$4,079.44
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $262.10 / $330.53 / $500.00	Professional	80	$262.10	$330.53	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $262.10 / $262.10 / $330.53	Professional	AS	$262.10	$262.10	$330.53
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $13,325.92 / $16,647.28	Facility		$2,800.00	$13,325.92	$16,647.28
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $349.76 / $817.91 / $868.18	Facility	AS	$349.76	$817.91	$868.18
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,649.99 / $2,151.06 / $3,130.42	Facility		$1,649.99	$2,151.06	$3,130.42
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $688.01 / $688.01 / $688.01	Facility	80	$688.01	$688.01	$688.01
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $200.73 / $200.73 / $584.80	Facility	AS	$200.73	$200.73	$584.80
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