Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,534.75 / $5,063.00 / $9,488.00	Facility		$2,534.75	$5,063.00	$9,488.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,665.00 / $7,166.56 / $19,770.82	Facility		$1,665.00	$7,166.56	$19,770.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5,112.60 / $5,555.39 / $8,531.48	Facility		$5,112.60	$5,555.39	$8,531.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,678.21 / $3,481.67 / $5,149.82	Professional		$2,678.21	$3,481.67	$5,149.82
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $12,082.64 / $12,082.64 / $12,082.64	Professional	22	$12,082.64	$12,082.64	$12,082.64
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $3,775.83 / $3,775.83 / $3,775.83	Professional	62	$3,775.83	$3,775.83	$3,775.83
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $322.20 / $322.20 / $322.20	Professional	80	$322.20	$322.20	$322.20
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $161.10 / $161.10 / $161.10	Professional	AS	$161.10	$161.10	$161.10
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