Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,561.85 / $9,674.00 / $22,788.00	Facility		$1,561.85	$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 $171.20 / $171.20 / $171.20	Facility	AS	$171.20	$171.20	$171.20
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $816.08 / $1,234.97 / $2,148.26	Professional		$816.08	$1,234.97	$2,148.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,403.80 / $1,835.03 / $3,362.41	Professional		$1,403.80	$1,835.03	$3,362.41
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $179.38 / $226.20 / $500.00	Professional	80	$179.38	$226.20	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $179.38 / $179.38 / $226.20	Professional	AS	$179.38	$179.38	$226.20
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $13,882.24 / $14,181.04	Facility		$55.00	$13,882.24	$14,181.04
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $299.32 / $699.99 / $740.90	Facility	AS	$299.32	$699.99	$740.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,468.02 / $1,896.26 / $2,745.60	Facility		$1,468.02	$1,896.26	$2,745.60
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $587.66 / $587.66 / $587.66	Facility	80	$587.66	$587.66	$587.66
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $171.20 / $171.20 / $499.52	Facility	AS	$171.20	$171.20	$499.52
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