Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,218.26 / $5,917.00 / $16,908.00	Facility		$2,218.26	$5,917.00	$16,908.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,226.13 / $9,454.90 / $26,321.46	Facility		$2,226.13	$9,454.90	$26,321.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,660.20 / $2,193.65 / $3,025.72	Facility		$1,660.20	$2,193.65	$3,025.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,799.47 / $1,799.47 / $19,311.37	Facility		$1,799.47	$1,799.47	$19,311.37
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,113.57 / $1,113.57 / $1,113.57	Facility	62	$1,113.57	$1,113.57	$1,113.57
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $178.17 / $178.17 / $178.17	Facility	AS	$178.17	$178.17	$178.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,737.30 / $2,669.12 / $4,095.34	Professional		$1,737.30	$2,669.12	$4,095.34
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,697.95 / $4,697.95 / $4,697.95	Professional	22	$4,697.95	$4,697.95	$4,697.95
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,468.11 / $1,468.11 / $1,468.11	Professional	62	$1,468.11	$1,468.11	$1,468.11
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $125.28 / $125.28 / $125.28	Professional	80	$125.28	$125.28	$125.28
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $62.64 / $62.64 / $62.64	Professional	AS	$62.64	$62.64	$62.64
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