Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,049.21 / $9,665.00 / $22,788.00	Facility		$1,049.21	$9,665.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $8,947.00 / $19,298.00	Facility		$2,873.70	$8,947.00	$19,298.00
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 $117.55 / $117.55 / $117.55	Facility	AS	$117.55	$117.55	$117.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $684.29 / $1,035.53 / $1,466.60	Professional		$684.29	$1,035.53	$1,466.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $959.44 / $1,251.95 / $2,301.71	Professional		$959.44	$1,251.95	$2,301.71
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $150.71 / $190.06 / $500.00	Professional	80	$150.71	$190.06	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $150.71 / $150.71 / $190.06	Professional	AS	$150.71	$150.71	$190.06
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $9,482.71 / $9,711.68	Facility		$55.00	$9,482.71	$9,711.68
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $204.78 / $479.42 / $506.37	Facility	AS	$204.78	$479.42	$506.37
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,001.56 / $1,279.25 / $2,003.12	Facility		$1,001.56	$1,279.25	$2,003.12
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $402.40 / $402.40 / $402.40	Facility	80	$402.40	$402.40	$402.40
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $117.55 / $117.55 / $342.04	Facility	AS	$117.55	$117.55	$342.04
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