Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,700.00 / $8,743.00 / $20,509.00	Facility		$2,700.00	$8,743.00	$20,509.00
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 / $11,939.24	Facility		$63.90	$100.00	$11,939.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $633.00 / $1,879.13 / $13,577.00	Facility		$633.00	$1,879.13	$13,577.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $184.06 / $184.06 / $184.06	Facility	AS	$184.06	$184.06	$184.06
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,221.52 / $1,774.60 / $2,310.65	Professional		$1,221.52	$1,774.60	$2,310.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,505.81 / $1,966.28 / $3,619.62	Professional		$1,505.81	$1,966.28	$3,619.62
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $268.64 / $338.79 / $500.00	Professional	80	$268.64	$338.79	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $268.64 / $268.64 / $338.79	Professional	AS	$268.64	$268.64	$338.79
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $12,235.92 / $15,231.52	Facility		$2,800.00	$12,235.92	$15,231.52
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $320.55 / $750.25 / $794.73	Facility	AS	$320.55	$750.25	$794.73
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,567.08 / $2,014.74 / $2,892.35	Facility		$1,567.08	$2,014.74	$2,892.35
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $632.51 / $632.51 / $632.51	Facility	80	$632.51	$632.51	$632.51
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $184.06 / $184.06 / $537.63	Facility	AS	$184.06	$184.06	$537.63
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