Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,019.58 / $9,674.00 / $22,788.00	Facility		$1,019.58	$9,674.00	$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 $112.52 / $112.52 / $112.52	Facility	AS	$112.52	$112.52	$112.52
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $590.47 / $893.56 / $1,427.22	Professional		$590.47	$893.56	$1,427.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $926.37 / $1,209.94 / $2,312.96	Professional		$926.37	$1,209.94	$2,312.96
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $129.82 / $163.71 / $500.00	Professional	80	$129.82	$163.71	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $129.82 / $129.82 / $163.71	Professional	AS	$129.82	$129.82	$163.71
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $9,109.44 / $9,334.71	Facility		$55.00	$9,109.44	$9,334.71
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $195.86 / $458.54 / $488.92	Facility	AS	$195.86	$458.54	$488.92
Providence Facility/Professional Facility Modifier Low / Median / High Price $967.95 / $1,258.33 / $1,815.00	Facility		$967.95	$1,258.33	$1,815.00
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $384.54 / $384.54 / $384.54	Facility	80	$384.54	$384.54	$384.54
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $112.52 / $112.52 / $326.86	Facility	AS	$112.52	$112.52	$326.86
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