Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.30 / $3,782.90 / $6,915.00	Facility		$1,288.30	$3,782.90	$6,915.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,209.49 / $1,569.23 / $3,838.67	Professional		$1,209.49	$1,569.23	$3,838.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,135.89 / $2,987.00 / $6,315.83	Facility		$1,135.89	$2,987.00	$6,315.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,306.58 / $1,895.00 / $3,238.18	Professional		$1,306.58	$1,895.00	$3,238.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,485.03 / $2,059.62 / $5,528.46	Facility		$1,485.03	$2,059.62	$5,528.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,420.43 / $1,633.53 / $1,675.13	Professional		$1,420.43	$1,633.53	$1,675.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,170.48 / $1,578.53 / $2,914.15	Professional		$1,170.48	$1,578.53	$2,914.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,633.53 / $1,846.56 / $3,320.58	Professional		$1,633.53	$1,846.56	$3,320.58
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,993.99 / $2,993.99 / $2,993.99	Professional	22	$2,993.99	$2,993.99	$2,993.99
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $935.62 / $935.62 / $935.62	Professional	62	$935.62	$935.62	$935.62
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $79.84 / $79.84 / $79.84	Professional	80	$79.84	$79.84	$79.84
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $39.92 / $39.92 / $39.92	Professional	AS	$39.92	$39.92	$39.92
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,689.00 / $8,836.00	Facility		$1,519.00	$6,689.00	$8,836.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,259.09 / $1,950.99 / $3,523.38	Professional		$1,259.09	$1,950.99	$3,523.38