Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,013.85 / $6,726.00 / $17,922.00	Facility		$2,013.85	$6,726.00	$17,922.00
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 $1,905.98 / $2,522.48 / $3,479.28	Facility		$1,905.98	$2,522.48	$3,479.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,059.71 / $4,778.00	Facility		$500.00	$2,059.71	$4,778.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,274.33 / $1,274.33 / $1,274.33	Facility	62	$1,274.33	$1,274.33	$1,274.33
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $203.90 / $203.90 / $203.90	Facility	AS	$203.90	$203.90	$203.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,995.15 / $3,065.27 / $9,357.00	Professional		$1,995.15	$3,065.27	$9,357.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,395.21 / $5,395.21 / $5,395.21	Professional	22	$5,395.21	$5,395.21	$5,395.21
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,686.00 / $1,686.00 / $1,686.00	Professional	62	$1,686.00	$1,686.00	$1,686.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $143.87 / $143.87 / $143.87	Professional	80	$143.87	$143.87	$143.87
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $71.94 / $71.94 / $71.94	Professional	AS	$71.94	$71.94	$71.94
United Facility/Professional Facility Modifier Low / Median / High Price $2,995.00 / $11,740.00 / $33,931.00	Facility		$2,995.00	$11,740.00	$33,931.00