Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,304.00 / $10,976.00 / $41,016.00	Facility		$4,304.00	$10,976.00	$41,016.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,089.46 / $3,089.46 / $15,938.11	Facility	22	$3,089.46	$3,089.46	$15,938.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,738.00 / $12,360.00 / $24,456.00	Facility		$3,738.00	$12,360.00	$24,456.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $12,897.90	Facility		$66.70	$100.00	$12,897.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,185.09 / $12,122.00 / $14,932.00	Facility		$6,185.09	$12,122.00	$14,932.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $748.40 / $1,017.68 / $1,373.87	Professional		$748.40	$1,017.68	$1,373.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $913.49 / $1,170.33 / $2,098.17	Professional		$913.49	$1,170.33	$2,098.17
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 $5,889.10 / $5,897.00 / $27,770.10	Facility		$5,889.10	$5,897.00	$27,770.10
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $205.32 / $2,632.21 / $2,632.21	Facility	AS	$205.32	$2,632.21	$2,632.21
Providence Facility/Professional Facility Modifier Low / Median / High Price $925.86 / $1,221.22 / $1,773.50	Facility		$925.86	$1,221.22	$1,773.50
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $346.77 / $346.77 / $346.77	Facility	80	$346.77	$346.77	$346.77
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $294.75 / $294.75 / $294.75	Facility	AS	$294.75	$294.75	$294.75
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