Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,765.10 / $10,321.00 / $22,788.00	Facility		$2,765.10	$10,321.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,473.23 / $9,771.00 / $21,405.00	Facility		$3,473.23	$9,771.00	$21,405.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.90 / $100.00 / $10,378.59	Facility		$63.90	$100.00	$10,378.59
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 62 Low / Median / High Price $2,171.67 / $2,171.67 / $2,171.67	Facility	62	$2,171.67	$2,171.67	$2,171.67
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $347.47 / $347.47 / $347.47	Facility	AS	$347.47	$347.47	$347.47
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,433.73 / $2,169.65 / $4,312.92	Professional		$1,433.73	$2,169.65	$4,312.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,827.02 / $3,684.94 / $7,118.43	Professional		$2,827.02	$3,684.94	$7,118.43
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $315.33 / $397.67 / $500.00	Professional	80	$315.33	$397.67	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $315.33 / $315.33 / $397.67	Professional	AS	$315.33	$315.33	$397.67
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $31,452.39 / $32,221.71	Facility		$55.00	$31,452.39	$32,221.71
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $3,779.11 / $8,852.98 / $9,325.23	Facility	62	$3,779.11	$8,852.98	$9,325.23
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $604.66 / $1,416.48 / $1,492.04	Facility	AS	$604.66	$1,416.48	$1,492.04
Providence Facility/Professional Facility Modifier Low / Median / High Price $2,947.95 / $3,713.50 / $5,267.17	Facility		$2,947.95	$3,713.50	$5,267.17
Providence Facility/Professional Facility Modifier 62 Low / Median / High Price $2,171.67 / $2,171.67 / $4,648.87	Facility	62	$2,171.67	$2,171.67	$4,648.87
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $1,190.10 / $1,190.10 / $1,190.10	Facility	80	$1,190.10	$1,190.10	$1,190.10
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $347.47 / $347.47 / $1,011.59	Facility	AS	$347.47	$347.47	$1,011.59
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