Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $868.13 / $9,674.00 / $22,788.00	Facility		$868.13	$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 $66.70 / $100.00 / $5,367.09	Facility		$66.70	$100.00	$5,367.09
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 $96.41 / $96.41 / $96.41	Facility	AS	$96.41	$96.41	$96.41
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $421.82 / $638.33 / $1,225.68	Professional		$421.82	$638.33	$1,225.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.89 / $1,037.10 / $1,969.47	Professional		$794.89	$1,037.10	$1,969.47
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $92.96 / $117.24 / $500.00	Professional	80	$92.96	$117.24	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $92.96 / $92.96 / $117.24	Professional	AS	$92.96	$92.96	$117.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $7,804.32 / $7,990.00	Facility		$55.00	$7,804.32	$7,990.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $167.84 / $393.29 / $419.53	Facility	AS	$167.84	$393.29	$419.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $825.41 / $1,039.50 / $1,457.30	Facility		$825.41	$1,039.50	$1,457.30
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $329.55 / $329.55 / $329.55	Facility	80	$329.55	$329.55	$329.55
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $96.41 / $96.41 / $280.12	Facility	AS	$96.41	$96.41	$280.12
United Facility/Professional Facility Modifier Low / Median / High Price $1,134.00 / $4,675.00 / $20,279.00	Facility		$1,134.00	$4,675.00	$20,279.00