Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $881.13 / $3,987.75 / $10,374.00	Facility		$881.13	$3,987.75	$10,374.00
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 $844.18 / $844.18 / $844.18	Facility		$844.18	$844.18	$844.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.42 / $550.42 / $6,386.00	Facility		$550.42	$550.42	$6,386.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $337.64 / $337.64 / $337.64	Facility	62	$337.64	$337.64	$337.64
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	AS	$54.02	$54.02	$54.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $529.29 / $813.18 / $3,537.00	Professional		$529.29	$813.18	$3,537.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,431.29 / $1,431.29 / $1,431.29	Professional	22	$1,431.29	$1,431.29	$1,431.29
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $447.28 / $447.28 / $447.28	Professional	62	$447.28	$447.28	$447.28
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $38.17 / $38.17 / $38.17	Professional	80	$38.17	$38.17	$38.17
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $19.07 / $19.07 / $19.07	Professional	AS	$19.07	$19.07	$19.07
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