Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,032.13 / $5,063.00 / $7,421.00	Facility		$2,032.13	$5,063.00	$7,421.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,282.27 / $5,155.99 / $21,657.35	Facility		$1,282.27	$5,155.99	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,270.10 / $2,270.10 / $2,270.10	Facility		$2,270.10	$2,270.10	$2,270.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,720.92 / $2,500.00	Facility		$500.00	$1,720.92	$2,500.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,069.99 / $1,069.99 / $1,069.99	Facility	62	$1,069.99	$1,069.99	$1,069.99
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $171.20 / $171.20 / $171.20	Facility	AS	$171.20	$171.20	$171.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,672.04 / $2,542.34 / $4,557.18	Professional		$1,672.04	$2,542.34	$4,557.18
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,521.50 / $4,521.50 / $4,521.50	Professional	22	$4,521.50	$4,521.50	$4,521.50
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,412.97 / $1,412.97 / $1,412.97	Professional	62	$1,412.97	$1,412.97	$1,412.97
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $120.57 / $120.57 / $120.57	Professional	80	$120.57	$120.57	$120.57
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.29 / $60.29 / $60.29	Professional	AS	$60.29	$60.29	$60.29
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