Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $332.72 / $4,749.25 / $18,997.00	Facility		$332.72	$4,749.25	$18,997.00
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 $559.58 / $559.58 / $559.58	Facility		$559.58	$559.58	$559.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $368.90 / $368.90 / $2,266.00	Facility		$368.90	$368.90	$2,266.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $225.79 / $225.79 / $225.79	Facility	62	$225.79	$225.79	$225.79
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $36.13 / $36.13 / $36.13	Facility	AS	$36.13	$36.13	$36.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $352.86 / $542.12 / $1,167.02	Professional		$352.86	$542.12	$1,167.02
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $954.19 / $954.19 / $954.19	Professional	22	$954.19	$954.19	$954.19
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $298.19 / $298.19 / $298.19	Professional	62	$298.19	$298.19	$298.19
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $25.45 / $25.45 / $25.45	Professional	80	$25.45	$25.45	$25.45
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $12.72 / $12.72 / $12.72	Professional	AS	$12.72	$12.72	$12.72
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