Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,997.33 / $10,321.00 / $22,788.00	Facility		$1,997.33	$10,321.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,275.00 / $9,624.00 / $20,634.00	Facility		$2,275.00	$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 / $2,151.00 / $14,932.00	Facility		$633.00	$2,151.00	$14,932.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $218.55 / $218.55 / $218.55	Facility	AS	$218.55	$218.55	$218.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,011.17 / $1,530.19 / $2,759.76	Professional		$1,011.17	$1,530.19	$2,759.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,793.75 / $2,344.03 / $4,448.45	Professional		$1,793.75	$2,344.03	$4,448.45
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $222.38 / $280.43 / $500.00	Professional	80	$222.38	$280.43	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $222.38 / $222.38 / $280.43	Professional	AS	$222.38	$222.38	$280.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $14,479.04 / $18,131.52	Facility		$2,800.00	$14,479.04	$18,131.52
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $379.94 / $889.06 / $946.70	Facility	AS	$379.94	$889.06	$946.70
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,795.80 / $2,344.69 / $3,424.14	Facility		$1,795.80	$2,344.69	$3,424.14
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $748.78 / $748.78 / $748.78	Facility	80	$748.78	$748.78	$748.78
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $218.55 / $218.55 / $636.46	Facility	AS	$218.55	$218.55	$636.46
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