Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,095.08 / $9,674.00 / $22,788.00	Facility		$1,095.08	$9,674.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $7,721.00 / $16,991.00	Facility		$2,456.00	$7,721.00	$16,991.00
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 $120.64 / $120.64 / $120.64	Facility	AS	$120.64	$120.64	$120.64
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $611.32 / $925.10 / $1,553.76	Professional		$611.32	$925.10	$1,553.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,002.10 / $1,310.44 / $2,488.81	Professional		$1,002.10	$1,310.44	$2,488.81
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $134.32 / $169.40 / $500.00	Professional	80	$134.32	$169.40	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $134.32 / $134.32 / $169.40	Professional	AS	$134.32	$134.32	$169.40
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $7,360.32 / $7,537.44	Facility		$55.00	$7,360.32	$7,537.44
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $210.24 / $492.14 / $528.88	Facility	AS	$210.24	$492.14	$528.88
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,047.97 / $1,336.13 / $1,837.18	Facility		$1,047.97	$1,336.13	$1,837.18
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $410.49 / $410.49 / $410.49	Facility	80	$410.49	$410.49	$410.49
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $120.64 / $120.64 / $348.92	Facility	AS	$120.64	$120.64	$348.92
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