Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $7,079.46 / $19,054.61	Facility		$3,235.94	$7,079.46	$19,054.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $6,309.57 / $23,988.33	Facility		$2,238.72	$6,309.57	$23,988.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,630.27 / $3,630.78	Facility		$2,137.96	$2,630.27	$3,630.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $3,090.30 / $4,786.30	Facility		$501.19	$3,090.30	$4,786.30
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,715.35 / $3,715.35 / $3,715.35	Facility	22	$3,715.35	$3,715.35	$3,715.35
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,949.84 / $1,949.84 / $1,949.84	Facility	62	$1,949.84	$1,949.84	$1,949.84
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $309.03 / $309.03 / $309.03	Facility	AS	$309.03	$309.03	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $2,818.38 / $10,232.93	Professional		$1,949.84	$2,818.38	$10,232.93
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Professional	22	$5,370.32	$5,370.32	$5,370.32
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional	62	$1,698.24	$1,698.24	$1,698.24
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	80	$144.54	$144.54	$144.54
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	AS	$72.44	$72.44	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $10,000.00 / $28,183.83	Facility		$3,019.95	$10,000.00	$28,183.83