Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $803.50 / $3,391.00 / $9,498.50	Facility		$803.50	$3,391.00	$9,498.50
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 $761.07 / $1,008.60 / $1,395.64	Facility		$761.07	$1,008.60	$1,395.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $825.13 / $5,845.00 / $9,852.00	Facility		$825.13	$5,845.00	$9,852.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $506.10 / $506.10 / $506.10	Facility	62	$506.10	$506.10	$506.10
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.98 / $80.98 / $80.98	Facility	AS	$80.98	$80.98	$80.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $792.47 / $1,217.53 / $1,785.81	Professional		$792.47	$1,217.53	$1,785.81
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $669.68 / $669.68 / $669.68	Professional	62	$669.68	$669.68	$669.68
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $57.15 / $57.15 / $57.15	Professional	80	$57.15	$57.15	$57.15
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.57 / $28.57 / $28.57	Professional	AS	$28.57	$28.57	$28.57
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,193.00 / $24,000.00	Facility		$1,998.00	$9,193.00	$24,000.00