Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,040.00 / $10,454.00 / $22,788.00	Facility		$4,040.00	$10,454.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,988.00 / $13,707.00 / $30,857.00	Facility		$1,988.00	$13,707.00	$30,857.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $14,865.02	Facility		$67.90	$100.00	$14,865.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $766.00 / $7,309.65 / $16,518.00	Facility		$766.00	$7,309.65	$16,518.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $125.45 / $125.45 / $125.45	Facility	AS	$125.45	$125.45	$125.45
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $657.48 / $1,219.50 / $1,646.33	Professional		$657.48	$1,219.50	$1,646.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,031.33 / $1,343.30 / $2,468.58	Professional		$1,031.33	$1,343.30	$2,468.58
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $144.56 / $182.30 / $500.00	Professional	80	$144.56	$182.30	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $144.56 / $144.56 / $182.30	Professional	AS	$144.56	$144.56	$182.30
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $8,371.20 / $10,160.00 / $27,770.10	Facility		$8,371.20	$10,160.00	$27,770.10
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $246.48 / $2,632.21 / $2,632.21	Facility	AS	$246.48	$2,632.21	$2,632.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,001.73 / $1,346.50 / $2,147.08	Facility		$1,001.73	$1,346.50	$2,147.08
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $428.61 / $428.61 / $428.61	Facility	80	$428.61	$428.61	$428.61
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $125.45 / $125.45 / $364.32	Facility	AS	$125.45	$125.45	$364.32
United Facility/Professional Facility Modifier Low / Median / High Price $4,578.00 / $13,171.00 / $29,312.00	Facility		$4,578.00	$13,171.00	$29,312.00