Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $623.84 / $3,391.00 / $6,915.00	Facility		$623.84	$3,391.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $522.46 / $2,178.00 / $6,065.87	Facility		$522.46	$2,178.00	$6,065.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $611.73 / $611.73 / $611.73	Facility		$611.73	$611.73	$611.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $410.86 / $410.86 / $2,500.00	Facility		$410.86	$410.86	$2,500.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $251.89 / $251.89 / $251.89	Facility	62	$251.89	$251.89	$251.89
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $40.29 / $40.29 / $40.29	Facility	AS	$40.29	$40.29	$40.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $395.62 / $607.80 / $1,282.16	Professional		$395.62	$607.80	$1,282.16
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,069.80 / $1,069.80 / $1,069.80	Professional	22	$1,069.80	$1,069.80	$1,069.80
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $334.31 / $334.31 / $334.31	Professional	62	$334.31	$334.31	$334.31
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $28.53 / $28.53 / $28.53	Professional	80	$28.53	$28.53	$28.53
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $14.26 / $14.26 / $14.26	Professional	AS	$14.26	$14.26	$14.26
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00