Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,453.55 / $5,063.00 / $7,631.00	Facility		$2,453.55	$5,063.00	$7,631.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,361.69 / $8,967.21 / $21,657.35	Facility		$2,361.69	$8,967.21	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,532.43 / $3,532.43 / $3,532.43	Facility		$3,532.43	$3,532.43	$3,532.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,500.00 / $2,733.97	Facility		$500.00	$2,500.00	$2,733.97
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,688.18 / $1,688.18 / $1,688.18	Facility	62	$1,688.18	$1,688.18	$1,688.18
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $270.11 / $270.11 / $270.11	Facility	AS	$270.11	$270.11	$270.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,630.05 / $4,040.71 / $14,904.27	Professional		$2,630.05	$4,040.71	$14,904.27
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $2,222.53 / $2,222.53 / $2,222.53	Professional	62	$2,222.53	$2,222.53	$2,222.53
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $189.66 / $189.66 / $189.66	Professional	80	$189.66	$189.66	$189.66
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $94.83 / $94.83 / $94.83	Professional	AS	$94.83	$94.83	$94.83
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00