Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,771.00 / $5,137.00 / $9,385.00	Facility		$2,771.00	$5,137.00	$9,385.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $829.97 / $829.97 / $1,463.39	Facility	52	$829.97	$829.97	$1,463.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,226.13 / $6,732.00 / $32,952.16	Facility		$2,226.13	$6,732.00	$32,952.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,804.18 / $3,351.42 / $4,558.91	Facility		$2,804.18	$3,351.42	$4,558.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,821.59 / $41,600.00	Facility		$500.00	$1,821.59	$41,600.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,440.27 / $1,440.27 / $1,440.27	Facility	52	$1,440.27	$1,440.27	$1,440.27
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $180.03 / $180.03 / $180.03	Facility	AS	$180.03	$180.03	$180.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,750.13 / $2,563.81 / $11,220.00	Professional		$1,750.13	$2,563.81	$11,220.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,732.67 / $4,732.67 / $4,732.67	Professional	22	$4,732.67	$4,732.67	$4,732.67
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,380.36 / $1,380.36 / $1,380.36	Professional	52	$1,380.36	$1,380.36	$1,380.36
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $63.10 / $63.10 / $63.10	Professional	AS	$63.10	$63.10	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $8,294.00 / $30,000.00	Facility		$1,738.00	$8,294.00	$30,000.00