Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,371.00 / $9,358.00 / $22,788.00	Facility		$3,371.00	$9,358.00	$22,788.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,734.00 / $12,014.00 / $25,103.02	Facility		$4,734.00	$12,014.00	$25,103.02
Blue Shield Facility/Professional Facility Modifier Low / Median / High Price $63.50 / $100.00 / $5,485.17	Facility		$63.50	$100.00	$5,485.17
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 $880.12 / $1,287.77 / $1,545.32	Professional		$880.12	$1,287.77	$1,545.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,158.99 / $1,488.85 / $2,706.32	Professional		$1,158.99	$1,488.85	$2,706.32
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 / $15,140.95	Facility		$2,800.00	$10,160.00	$15,140.95
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $232.57 / $544.37 / $576.66	Facility	AS	$232.57	$544.37	$576.66
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,189.32 / $1,533.21 / $2,282.64	Facility		$1,189.32	$1,533.21	$2,282.64
Providence Facility/Professional Facility Modifier 80 Low / Median / High Price $452.51 / $452.51 / $452.51	Facility	80	$452.51	$452.51	$452.51
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $384.63 / $384.63 / $384.63	Facility	AS	$384.63	$384.63	$384.63
United Facility/Professional Facility Modifier Low / Median / High Price $5,835.00 / $12,434.00 / $26,672.00	Facility		$5,835.00	$12,434.00	$26,672.00