Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,202.00 / $6,014.00 / $16,939.43	Facility		$1,202.00	$6,014.00	$16,939.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,063.95 / $7,200.00 / $39,007.80	Facility		$1,063.95	$7,200.00	$39,007.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,060.19 / $1,060.19 / $1,060.19	Facility		$1,060.19	$1,060.19	$1,060.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $809.07 / $2,500.00	Facility		$500.00	$809.07	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.45 / $80.45 / $80.45	Facility	AS	$80.45	$80.45	$80.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $785.71 / $1,182.69 / $1,971.58	Professional		$785.71	$1,182.69	$1,971.58
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,124.69 / $2,124.69 / $2,124.69	Professional	22	$2,124.69	$2,124.69	$2,124.69
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $56.66 / $56.66 / $56.66	Professional	80	$56.66	$56.66	$56.66
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.33 / $28.33 / $28.33	Professional	AS	$28.33	$28.33	$28.33
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00