Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,113.45 / $10,247.59 / $25,694.00	Facility		$3,113.45	$10,247.59	$25,694.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,559.00 / $4,483.00 / $6,136.00	Facility	22	$3,559.00	$4,483.00	$6,136.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $7,140.00 / $15,529.00	Facility		$1,450.00	$7,140.00	$15,529.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $12,803.12	Facility		$67.90	$100.00	$12,803.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $643.00 / $1,025.00 / $13,439.00	Facility		$643.00	$1,025.00	$13,439.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $67.78 / $67.78 / $67.78	Facility	AS	$67.78	$67.78	$67.78
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $273.27 / $413.53 / $865.22	Professional		$273.27	$413.53	$865.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $560.04 / $730.25 / $1,346.71	Professional		$560.04	$730.25	$1,346.71
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $60.20 / $75.92 / $500.00	Professional	80	$60.20	$75.92	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.20 / $60.20 / $75.92	Professional	AS	$60.20	$60.20	$75.92
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $10,160.00 / $13,486.75	Facility		$2,800.00	$10,160.00	$13,486.75
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $133.66 / $1,279.44 / $1,279.44	Facility	AS	$133.66	$1,279.44	$1,279.44
Providence Facility/Professional Facility Modifier Low / Median / High Price $582.66 / $757.46 / $1,128.95	Facility		$582.66	$757.46	$1,128.95
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $231.39 / $231.39 / $231.39	Facility	80	$231.39	$231.39	$231.39
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $67.78 / $67.78 / $196.68	Facility	AS	$67.78	$67.78	$196.68
United Facility/Professional Facility Modifier Low / Median / High Price $4,169.00 / $13,245.00 / $29,571.00	Facility		$4,169.00	$13,245.00	$29,571.00