Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,992.00 / $8,090.00 / $20,509.00	Facility		$1,992.00	$8,090.00	$20,509.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,800.00 / $8,441.00 / $18,150.00	Facility		$1,800.00	$8,441.00	$18,150.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $67.90 / $100.00 / $19,707.12	Facility		$67.90	$100.00	$19,707.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $716.00 / $4,450.43 / $8,127.02	Facility		$716.00	$4,450.43	$8,127.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.59 / $80.59 / $80.59	Facility	AS	$80.59	$80.59	$80.59
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $472.82 / $787.28 / $1,062.83	Professional		$472.82	$787.28	$1,062.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $664.85 / $866.22 / $1,598.32	Professional		$664.85	$866.22	$1,598.32
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $104.02 / $131.16 / $500.00	Professional	80	$104.02	$131.16	$500.00
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $104.02 / $104.02 / $131.18	Professional	AS	$104.02	$104.02	$131.18
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $3,366.65 / $17,986.75 / $26,542.00	Facility		$3,366.65	$17,986.75	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $158.81 / $1,704.89 / $1,704.89	Facility	AS	$158.81	$1,704.89	$1,704.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $701.31 / $915.88 / $1,458.62	Facility		$701.31	$915.88	$1,458.62
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $275.33 / $275.33 / $275.33	Facility	80	$275.33	$275.33	$275.33
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $80.59 / $80.59 / $234.03	Facility	AS	$80.59	$80.59	$234.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,922.60 / $9,606.00 / $21,278.00	Facility		$2,922.60	$9,606.00	$21,278.00