Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,787.89 / $5,063.00 / $8,331.00	Facility		$1,787.89	$5,063.00	$8,331.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,783.00 / $6,291.00 / $16,577.00	Facility	50	$3,783.00	$6,291.00	$16,577.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,434.34 / $4,845.66 / $10,832.53	Facility		$1,434.34	$4,845.66	$10,832.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,237.08 / $1,494.81 / $2,432.91	Facility		$1,237.08	$1,494.81	$2,432.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,388.37 / $6,918.00 / $9,852.00	Facility		$3,388.37	$6,918.00	$9,852.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,083.29 / $1,408.28 / $4,146.47	Professional		$1,083.29	$1,408.28	$4,146.47
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,524.19 / $2,524.19 / $2,524.19	Professional	22	$2,524.19	$2,524.19	$2,524.19
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $33.65 / $33.65 / $33.65	Professional	AS	$33.65	$33.65	$33.65
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $7,794.00 / $14,048.00	Facility		$1,738.00	$7,794.00	$14,048.00