Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,969.72 / $6,014.00 / $12,464.00	Facility		$1,969.72	$6,014.00	$12,464.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,452.00 / $16,585.74 / $55,752.34	Facility		$2,452.00	$16,585.74	$55,752.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,912.51 / $1,912.51 / $1,912.51	Facility		$1,912.51	$1,912.51	$1,912.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,486.82 / $5,845.00 / $9,852.00	Facility		$1,486.82	$5,845.00	$9,852.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $925.06 / $925.06 / $925.06	Facility	62	$925.06	$925.06	$925.06
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $148.01 / $148.01 / $148.01	Facility	AS	$148.01	$148.01	$148.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,447.97 / $2,205.96 / $4,220.37	Professional		$1,447.97	$2,205.96	$4,220.37
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,915.55 / $3,915.55 / $3,915.55	Professional	22	$3,915.55	$3,915.55	$3,915.55
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,223.60 / $1,223.60 / $1,223.60	Professional	62	$1,223.60	$1,223.60	$1,223.60
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $104.41 / $104.41 / $104.41	Professional	80	$104.41	$104.41	$104.41
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $52.21 / $52.21 / $52.21	Professional	AS	$52.21	$52.21	$52.21
United Facility/Professional Facility Modifier Low / Median / High Price $2,303.00 / $10,133.00 / $25,511.00	Facility		$2,303.00	$10,133.00	$25,511.00