Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,616.00 / $8,479.00 / $19,368.00	Facility		$2,616.00	$8,479.00	$19,368.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,242.00 / $9,557.00 / $19,252.00	Facility		$3,242.00	$9,557.00	$19,252.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.00 / $100.00 / $11,343.07	Facility		$66.00	$100.00	$11,343.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,811.56 / $3,322.76 / $7,828.13	Facility		$2,811.56	$3,322.76	$7,828.13
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $430.70 / $692.07 / $934.29	Professional		$430.70	$692.07	$934.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $618.16 / $795.88 / $1,406.92	Professional		$618.16	$795.88	$1,406.92
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 $2,839.75 / $12,623.50 / $26,542.00	Facility		$2,839.75	$12,623.50	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $139.33 / $1,196.53 / $1,196.53	Facility	AS	$139.33	$1,196.53	$1,196.53
Providence Facility/Professional Facility Modifier Low / Median / High Price $591.85 / $767.41 / $1,109.33	Facility		$591.85	$767.41	$1,109.33
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $234.48 / $234.48 / $234.48	Facility	80	$234.48	$234.48	$234.48
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $199.31 / $199.31 / $199.31	Facility	AS	$199.31	$199.31	$199.31
United Facility/Professional Facility Modifier Low / Median / High Price $4,110.00 / $9,713.00 / $21,278.00	Facility		$4,110.00	$9,713.00	$21,278.00