Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $803.50 / $3,574.00 / $8,961.00	Facility		$803.50	$3,574.00	$8,961.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $22,373.24 / $26,321.46	Facility		$7,875.00	$22,373.24	$26,321.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $415.84 / $551.19 / $762.74	Facility		$415.84	$551.19	$762.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.12 / $450.12 / $3,775.00	Facility		$450.12	$450.12	$3,775.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $276.13 / $276.13 / $276.13	Facility	62	$276.13	$276.13	$276.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $44.18 / $44.18 / $44.18	Facility	AS	$44.18	$44.18	$44.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $433.08 / $665.37 / $2,515.00	Professional		$433.08	$665.37	$2,515.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,171.09 / $1,171.09 / $1,171.09	Professional	22	$1,171.09	$1,171.09	$1,171.09
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $365.97 / $365.97 / $365.97	Professional	62	$365.97	$365.97	$365.97
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $31.23 / $31.23 / $31.23	Professional	80	$31.23	$31.23	$31.23
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $15.61 / $15.61 / $15.61	Professional	AS	$15.61	$15.61	$15.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $9,736.00 / $23,643.00	Facility		$1,738.00	$9,736.00	$23,643.00