Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $954.25 / $3,460.00 / $9,488.00	Facility		$954.25	$3,460.00	$9,488.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $10,493.38 / $20,395.25 / $26,321.46	Facility		$10,493.38	$20,395.25	$26,321.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $799.99 / $1,060.14 / $1,466.66	Facility		$799.99	$1,060.14	$1,466.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $866.56 / $5,845.00 / $9,852.00	Facility		$866.56	$5,845.00	$9,852.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $531.50 / $531.50 / $531.50	Facility	62	$531.50	$531.50	$531.50
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $85.04 / $85.04 / $85.04	Facility	AS	$85.04	$85.04	$85.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $832.96 / $1,279.74 / $1,877.07	Professional		$832.96	$1,279.74	$1,877.07
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,252.48 / $2,252.48 / $2,252.48	Professional	22	$2,252.48	$2,252.48	$2,252.48
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $703.90 / $703.90 / $703.90	Professional	62	$703.90	$703.90	$703.90
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $60.07 / $60.07 / $60.07	Professional	80	$60.07	$60.07	$60.07
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $30.03 / $30.03 / $30.03	Professional	AS	$30.03	$30.03	$30.03
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,800.00 / $24,000.00	Facility		$175.00	$1,800.00	$24,000.00