Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,843.00 / $9,358.00 / $21,049.51	Facility		$2,843.00	$9,358.00	$21,049.51
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $14,238.94 / $14,238.94 / $14,238.94	Facility	50	$14,238.94	$14,238.94	$14,238.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,080.00 / $8,441.00 / $18,150.00	Facility		$2,080.00	$8,441.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $100.00 / $15,886.21	Facility		$69.80	$100.00	$15,886.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $750.00 / $2,364.98 / $5,927.32	Facility		$750.00	$2,364.98	$5,927.32
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $71.36 / $71.36 / $71.36	Facility	AS	$71.36	$71.36	$71.36
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $421.82 / $698.16 / $942.52	Professional		$421.82	$698.16	$942.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.38 / $766.88 / $1,450.00	Professional		$588.38	$766.88	$1,450.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $92.96 / $117.24 / $500.00	Professional	80	$92.96	$117.24	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $92.96 / $92.96 / $117.24	Professional	AS	$92.96	$92.96	$117.24
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,971.90 / $9,558.29 / $26,542.00	Facility		$2,971.90	$9,558.29	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $140.40 / $905.99 / $905.99	Facility	AS	$140.40	$905.99	$905.99
Providence Facility/Professional Facility Modifier Low / Median / High Price $612.92 / $799.93 / $1,227.22	Facility		$612.92	$799.93	$1,227.22
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $243.73 / $243.73 / $243.73	Facility	80	$243.73	$243.73	$243.73
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $71.36 / $71.36 / $207.17	Facility	AS	$71.36	$71.36	$207.17
United Facility/Professional Facility Modifier Low / Median / High Price $1,825.00 / $8,960.00 / $20,988.00	Facility		$1,825.00	$8,960.00	$20,988.00