Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $908.75 / $3,460.00 / $9,498.50	Facility		$908.75	$3,460.00	$9,498.50
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 $789.83 / $1,046.19 / $1,446.92	Facility		$789.83	$1,046.19	$1,446.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $858.77 / $858.77 / $3,350.00	Facility		$858.77	$858.77	$3,350.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $526.61 / $526.61 / $526.61	Facility	62	$526.61	$526.61	$526.61
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $84.26 / $84.26 / $84.26	Facility	AS	$84.26	$84.26	$84.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $822.01 / $1,262.90 / $1,852.36	Professional		$822.01	$1,262.90	$1,852.36
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,222.83 / $2,222.83 / $2,222.83	Professional	22	$2,222.83	$2,222.83	$2,222.83
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $694.64 / $694.64 / $694.64	Professional	62	$694.64	$694.64	$694.64
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $59.28 / $59.28 / $59.28	Professional	80	$59.28	$59.28	$59.28
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $29.64 / $29.64 / $29.64	Professional	AS	$29.64	$29.64	$29.64
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