Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,766.43 / $5,063.00 / $6,915.00	Facility		$2,766.43	$5,063.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,614.69 / $8,652.36 / $21,657.35	Facility		$1,614.69	$8,652.36	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4,452.02 / $4,452.02 / $4,452.02	Facility		$4,452.02	$4,452.02	$4,452.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,500.00 / $3,074.84	Facility		$500.00	$2,500.00	$3,074.84
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,890.19 / $1,890.19 / $1,890.19	Facility	62	$1,890.19	$1,890.19	$1,890.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,921.45 / $4,358.13 / $10,021.43	Professional		$2,921.45	$4,358.13	$10,021.43
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $12,025.72 / $12,025.72 / $12,025.72	Professional	22	$12,025.72	$12,025.72	$12,025.72
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $3,758.04 / $3,758.04 / $3,758.04	Professional	62	$3,758.04	$3,758.04	$3,758.04
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $320.69 / $320.69 / $320.69	Professional	80	$320.69	$320.69	$320.69
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