Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,771.00 / $5,063.00 / $7,767.00	Facility		$2,771.00	$5,063.00	$7,767.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $894.85 / $894.85 / $1,582.61	Facility	52	$894.85	$894.85	$1,582.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,452.00 / $10,174.93 / $39,007.80	Facility		$2,452.00	$10,174.93	$39,007.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,028.77 / $3,617.42 / $4,920.74	Facility		$3,028.77	$3,617.42	$4,920.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,967.28 / $41,600.00	Facility		$500.00	$1,967.28	$41,600.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,554.50 / $1,554.50 / $1,554.50	Facility	52	$1,554.50	$1,554.50	$1,554.50
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $194.31 / $194.31 / $194.31	Facility	AS	$194.31	$194.31	$194.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,889.04 / $2,769.25 / $12,213.00	Professional		$1,889.04	$2,769.25	$12,213.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,108.30 / $5,108.30 / $5,108.30	Professional	22	$5,108.30	$5,108.30	$5,108.30
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,489.92 / $1,489.92 / $1,489.92	Professional	52	$1,489.92	$1,489.92	$1,489.92
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $136.22 / $136.22 / $136.22	Professional	80	$136.22	$136.22	$136.22
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $68.11 / $68.11 / $68.11	Professional	AS	$68.11	$68.11	$68.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,725.00 / $9,193.00 / $18,878.00	Facility		$2,725.00	$9,193.00	$18,878.00