Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,588.75 / $9,674.00 / $22,788.00	Facility		$1,588.75	$9,674.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,873.70 / $10,247.00 / $21,842.00	Facility		$2,873.70	$10,247.00	$21,842.00
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 $178.17 / $178.17 / $178.17	Facility	AS	$178.17	$178.17	$178.17
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $463.89 / $702.00 / $2,239.59	Professional		$463.89	$702.00	$2,239.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,459.82 / $1,902.93 / $3,486.58	Professional		$1,459.82	$1,902.93	$3,486.58
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $101.97 / $128.60 / $500.00	Professional	80	$101.97	$128.60	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $101.97 / $101.97 / $128.60	Professional	AS	$101.97	$101.97	$128.60
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $12,580.75 / $12,879.79	Facility		$55.00	$12,580.75	$12,879.79
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $310.12 / $726.79 / $770.46	Facility	AS	$310.12	$726.79	$770.46
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,260.50 / $1,890.85 / $2,676.33	Facility		$1,260.50	$1,890.85	$2,676.33
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $609.64 / $609.64 / $609.64	Facility	80	$609.64	$609.64	$609.64
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $178.17 / $178.17 / $518.19	Facility	AS	$178.17	$178.17	$518.19
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