Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.00 / $4,590.00 / $6,915.00	Facility		$1,202.00	$4,590.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $550.07 / $958.34 / $1,135.14	Facility	52	$550.07	$958.34	$1,135.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,100.13 / $1,375.03 / $3,060.25	Professional		$1,100.13	$1,375.03	$3,060.25
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 $1,200.49 / $1,672.98 / $2,789.37	Professional		$1,200.49	$1,672.98	$2,789.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,092.97 / $1,479.22 / $2,604.48	Professional		$1,092.97	$1,479.22	$2,604.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,371.33 / $1,546.23 / $2,532.77	Professional		$1,371.33	$1,546.23	$2,532.77
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,513.42 / $2,513.42 / $2,513.42	Professional	22	$2,513.42	$2,513.42	$2,513.42
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $733.08 / $733.08 / $733.08	Professional	52	$733.08	$733.08	$733.08
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $67.02 / $67.02 / $67.02	Professional	80	$67.02	$67.02	$67.02
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $33.51 / $33.51 / $33.51	Professional	AS	$33.51	$33.51	$33.51
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 $1,175.22 / $1,882.71 / $2,947.09	Professional		$1,175.22	$1,882.71	$2,947.09