Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $7,413.10 / $19,054.61	Facility		$2,511.89	$7,413.10	$19,054.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,456.54 / $23,988.33	Facility		$2,238.72	$6,456.54	$23,988.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,454.71 / $3,388.44	Facility		$2,041.74	$2,454.71	$3,388.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $8,317.64 / $12,589.25	Facility		$2,884.03	$8,317.64	$12,589.25
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility	22	$3,467.37	$3,467.37	$3,467.37
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility	62	$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $288.40 / $288.40 / $288.40	Facility	AS	$288.40	$288.40	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $2,691.53 / $9,772.37	Professional		$1,819.70	$2,691.53	$9,772.37
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,128.61 / $5,128.61 / $5,128.61	Professional	22	$5,128.61	$5,128.61	$5,128.61
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Professional	62	$1,584.89	$1,584.89	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $134.90 / $134.90 / $134.90	Professional	80	$134.90	$134.90	$134.90
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	AS	$67.61	$67.61	$67.61
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $8,912.51 / $22,387.21	Facility		$2,454.71	$8,912.51	$22,387.21