Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,956.72 / $8,479.00 / $20,509.00	Facility		$1,956.72	$8,479.00	$20,509.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,619.00 / $8,484.00 / $18,150.00	Facility		$2,619.00	$8,484.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $5,177.85	Facility		$66.70	$100.00	$5,177.85
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 $131.97 / $131.97 / $131.97	Facility	AS	$131.97	$131.97	$131.97
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $649.29 / $982.57 / $1,676.73	Professional		$649.29	$982.57	$1,676.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,088.27 / $1,419.00 / $2,616.86	Professional		$1,088.27	$1,419.00	$2,616.86
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $142.91 / $180.25 / $500.00	Professional	80	$142.91	$180.25	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $142.91 / $142.91 / $180.25	Professional	AS	$142.91	$142.91	$180.25
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $10,687.04 / $10,930.40	Facility		$2,000.00	$10,687.04	$10,930.40
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $229.99 / $539.07 / $574.37	Facility	AS	$229.99	$539.07	$574.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,104.30 / $1,417.27 / $1,995.16	Facility		$1,104.30	$1,417.27	$1,995.16
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $450.84 / $450.84 / $450.84	Facility	80	$450.84	$450.84	$450.84
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $131.97 / $131.97 / $383.21	Facility	AS	$131.97	$131.97	$383.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,599.00 / $9,655.00 / $22,073.00	Facility		$2,599.00	$9,655.00	$22,073.00