Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,791.00 / $6,014.00 / $12,464.00	Facility		$1,791.00	$6,014.00	$12,464.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,452.00 / $18,685.16 / $55,752.34	Facility		$2,452.00	$18,685.16	$55,752.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,896.09 / $1,896.09 / $1,896.09	Facility		$1,896.09	$1,896.09	$1,896.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,463.39 / $5,845.00 / $9,852.00	Facility		$1,463.39	$5,845.00	$9,852.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $908.75 / $908.75 / $908.75	Facility	62	$908.75	$908.75	$908.75
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $145.40 / $145.40 / $145.40	Facility	AS	$145.40	$145.40	$145.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,424.16 / $2,159.57 / $3,332.02	Professional		$1,424.16	$2,159.57	$3,332.02
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,851.18 / $3,851.18 / $3,851.18	Professional	22	$3,851.18	$3,851.18	$3,851.18
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,203.50 / $1,203.50 / $1,203.50	Professional	62	$1,203.50	$1,203.50	$1,203.50
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $102.70 / $102.70 / $102.70	Professional	80	$102.70	$102.70	$102.70
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $51.35 / $51.35 / $51.35	Professional	AS	$51.35	$51.35	$51.35
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