Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,404.00 / $8,507.81 / $30,390.00	Facility		$2,404.00	$8,507.81	$30,390.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $12,232.00 / $12,232.00 / $12,232.00	Facility	22	$12,232.00	$12,232.00	$12,232.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,143.00 / $6,048.00 / $13,697.00	Facility		$2,143.00	$6,048.00	$13,697.00
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $66.70 / $100.00 / $16,382.99	Facility		$66.70	$100.00	$16,382.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,613.43 / $4,270.41 / $10,060.73	Facility		$3,613.43	$4,270.41	$10,060.73
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $553.98 / $795.34 / $1,073.71	Professional		$553.98	$795.34	$1,073.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $714.15 / $920.95 / $1,644.45	Professional		$714.15	$920.95	$1,644.45
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 $4,607.68 / $5,897.00 / $16,223.75	Facility		$4,607.68	$5,897.00	$16,223.75
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $159.36 / $1,537.78 / $1,537.78	Facility	AS	$159.36	$1,537.78	$1,537.78
Providence Facility/Professional Facility Modifier Low / Median / High Price $736.76 / $952.92 / $1,505.65	Facility		$736.76	$952.92	$1,505.65
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $269.81 / $269.81 / $269.81	Facility	80	$269.81	$269.81	$269.81
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $229.34 / $229.34 / $229.34	Facility	AS	$229.34	$229.34	$229.34
United Facility/Professional Facility Modifier Low / Median / High Price $6,341.00 / $13,555.00 / $29,312.00	Facility		$6,341.00	$13,555.00	$29,312.00