Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,225.50 / $8,830.00 / $21,834.50	Facility		$3,225.50	$8,830.00	$21,834.50
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $12,469.00 / $12,469.00 / $12,469.00	Facility	22	$12,469.00	$12,469.00	$12,469.00
Aetna Facility/Professional Facility Modifier 80 Low / Median / High Price $3,230.00 / $3,230.00 / $3,230.00	Facility	80	$3,230.00	$3,230.00	$3,230.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,275.00 / $9,644.00 / $19,252.00	Facility		$3,275.00	$9,644.00	$19,252.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $11,798.18	Facility		$66.70	$100.00	$11,798.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,613.43 / $11,684.00 / $14,696.00	Facility		$3,613.43	$11,684.00	$14,696.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $305.66 / $791.54 / $1,068.58	Professional		$305.66	$791.54	$1,068.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $712.39 / $911.00 / $1,621.14	Professional		$712.39	$911.00	$1,621.14
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 $4,627.77 / $16,223.75 / $26,542.00	Facility		$4,627.77	$16,223.75	$26,542.00
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $160.77 / $1,537.78 / $1,537.78	Facility	AS	$160.77	$1,537.78	$1,537.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $733.49 / $936.08 / $1,362.47	Facility		$733.49	$936.08	$1,362.47
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $271.73 / $271.73 / $271.73	Facility	80	$271.73	$271.73	$271.73
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $230.97 / $230.97 / $230.97	Facility	AS	$230.97	$230.97	$230.97
Sutter Health Plus Facility/Professional Facility Modifier Low / Median / High Price $8,321.00 / $8,321.00 / $8,321.00	Facility		$8,321.00	$8,321.00	$8,321.00
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $13,722.00 / $29,571.00	Facility		$7,212.00	$13,722.00	$29,571.00