Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,387.00 / $9,560.00 / $21,357.00	Facility		$2,387.00	$9,560.00	$21,357.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,456.00 / $9,771.00 / $21,405.00	Facility		$2,456.00	$9,771.00	$21,405.00
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 $126.27 / $126.27 / $126.27	Facility	AS	$126.27	$126.27	$126.27
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $618.02 / $935.24 / $1,587.33	Professional		$618.02	$935.24	$1,587.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,034.99 / $1,347.60 / $2,480.28	Professional		$1,034.99	$1,347.60	$2,480.28
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $135.96 / $171.46 / $500.00	Professional	80	$135.96	$171.46	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $135.96 / $135.96 / $171.46	Professional	AS	$135.96	$135.96	$171.46
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $5,413.00 / $8,558.00 / $10,417.04	Facility		$5,413.00	$8,558.00	$10,417.04
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $219.90 / $515.76 / $546.25	Facility	AS	$219.90	$515.76	$546.25
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,024.33 / $1,352.88 / $1,959.58	Facility		$1,024.33	$1,352.88	$1,959.58
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $432.98 / $432.98 / $432.98	Facility	80	$432.98	$432.98	$432.98
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $126.27 / $126.27 / $368.03	Facility	AS	$126.27	$126.27	$368.03
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