Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $9,608.00 / $19,894.00	Facility		$2,421.00	$9,608.00	$19,894.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,314.00 / $12,159.00 / $34,930.00	Facility		$4,314.00	$12,159.00	$34,930.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,277.00 / $2,277.00 / $2,277.00	Facility		$2,277.00	$2,277.00	$2,277.00
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $1,152.86 / $1,268.16 / $1,556.37	Professional		$1,152.86	$1,268.16	$1,556.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $938.12 / $1,301.48 / $2,253.55	Professional		$938.12	$1,301.48	$2,253.55
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $1,747.08 / $5,433.47 / $5,433.47	Facility		$1,747.08	$5,433.47	$5,433.47
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $149.71 / $462.93 / $503.71	Facility	AS	$149.71	$462.93	$503.71
Providence Facility/Professional Facility Modifier Low / Median / High Price $1,012.18 / $1,272.53 / $1,753.42	Facility		$1,012.18	$1,272.53	$1,753.42
Providence Facility/Professional Facility Modifier AS Low / Median / High Price $113.00 / $113.00 / $325.22	Facility	AS	$113.00	$113.00	$325.22
United Facility/Professional Facility Modifier Low / Median / High Price $7,212.00 / $13,651.00 / $29,312.00	Facility		$7,212.00	$13,651.00	$29,312.00