Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,044.69 / $9,674.00 / $22,788.00	Facility		$1,044.69	$9,674.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,675.00 / $8,805.92 / $18,758.00	Facility		$2,675.00	$8,805.92	$18,758.00
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 / $766.00 / $5,431.00	Facility		$633.00	$766.00	$5,431.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $115.95 / $115.95 / $115.95	Facility	AS	$115.95	$115.95	$115.95
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $611.32 / $925.10 / $1,466.44	Professional		$611.32	$925.10	$1,466.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $953.58 / $1,244.26 / $2,176.00	Professional		$953.58	$1,244.26	$2,176.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $134.32 / $169.40 / $500.00	Professional	80	$134.32	$169.40	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $134.32 / $134.32 / $169.40	Professional	AS	$134.32	$134.32	$169.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $9,382.64 / $9,601.60	Facility		$55.00	$9,382.64	$9,601.60
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $202.03 / $473.22 / $503.28	Facility	AS	$202.03	$473.22	$503.28
Providence Facility/Professional Facility Modifier Low / Median / High Price $995.41 / $1,288.05 / $1,819.12	Facility		$995.41	$1,288.05	$1,819.12
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $396.49 / $396.49 / $396.49	Facility	80	$396.49	$396.49	$396.49
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $115.95 / $115.95 / $337.02	Facility	AS	$115.95	$115.95	$337.02
United Facility/Professional Facility Modifier Low / Median / High Price $1,204.00 / $4,675.00 / $20,279.00	Facility		$1,204.00	$4,675.00	$20,279.00