Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.25 / $3,360.00 / $9,488.00	Facility		$462.25	$3,360.00	$9,488.00
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 $410.54 / $544.11 / $752.86	Facility		$410.54	$544.11	$752.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $444.46 / $444.46 / $9,270.00	Facility		$444.46	$444.46	$9,270.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $272.63 / $272.63 / $272.63	Facility	62	$272.63	$272.63	$272.63
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	AS	$43.62	$43.62	$43.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $427.52 / $656.82 / $1,331.15	Professional		$427.52	$656.82	$1,331.15
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,156.07 / $1,156.07 / $1,156.07	Professional	22	$1,156.07	$1,156.07	$1,156.07
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $361.27 / $361.27 / $361.27	Professional	62	$361.27	$361.27	$361.27
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $30.83 / $30.83 / $30.83	Professional	80	$30.83	$30.83	$30.83
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $15.41 / $15.41 / $15.41	Professional	AS	$15.41	$15.41	$15.41
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00