Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,201.00 / $9,674.00 / $22,788.00	Facility		$1,201.00	$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 $134.03 / $134.03 / $134.03	Facility	AS	$134.03	$134.03	$134.03
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $505.96 / $765.66 / $1,698.53	Professional		$505.96	$765.66	$1,698.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,103.20 / $1,438.29 / $2,714.00	Professional		$1,103.20	$1,438.29	$2,714.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $111.40 / $140.47 / $500.00	Professional	80	$111.40	$140.47	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $111.40 / $111.40 / $140.47	Professional	AS	$111.40	$111.40	$140.47
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $10,838.24 / $11,091.04	Facility		$55.00	$10,838.24	$11,091.04
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $233.34 / $546.94 / $582.25	Facility	AS	$233.34	$546.94	$582.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,104.19 / $1,437.46 / $2,022.54	Facility		$1,104.19	$1,437.46	$2,022.54
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $458.29 / $458.29 / $458.29	Facility	80	$458.29	$458.29	$458.29
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $134.03 / $134.03 / $389.54	Facility	AS	$134.03	$134.03	$389.54
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