Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,951.37 / $10,615.43 / $28,291.00	Facility		$3,951.37	$10,615.43	$28,291.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,403.00 / $9,830.00 / $19,252.00	Facility		$3,403.00	$9,830.00	$19,252.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $14,354.10	Facility		$66.70	$100.00	$14,354.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11,684.00 / $13,360.00 / $14,932.00	Facility		$11,684.00	$13,360.00	$14,932.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $798.58 / $1,208.50 / $1,632.72	Professional		$798.58	$1,208.50	$1,632.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,224.54 / $1,567.97 / $2,847.54	Professional		$1,224.54	$1,567.97	$2,847.54
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $500.00 / $500.00 / $500.00	Professional	80	$500.00	$500.00	$500.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $10,160.00 / $22,189.40	Facility		$2,800.00	$10,160.00	$22,189.40
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $283.62 / $2,105.03 / $2,105.03	Facility	AS	$283.62	$2,105.03	$2,105.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,306.64 / $1,686.18 / $2,401.69	Facility		$1,306.64	$1,686.18	$2,401.69
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $465.61 / $465.61 / $465.61	Facility	80	$465.61	$465.61	$465.61
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $395.77 / $395.77 / $395.77	Facility	AS	$395.77	$395.77	$395.77
United Facility/Professional Facility Modifier Low / Median / High Price $7,696.00 / $13,784.00 / $29,571.00	Facility		$7,696.00	$13,784.00	$29,571.00