Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $899.19 / $4,592.00 / $7,421.00	Facility		$899.19	$4,592.00	$7,421.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $5,435.54 / $12,227.65	Facility		$1,206.01	$5,435.54	$12,227.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,142.43 / $1,384.59 / $1,883.45	Facility		$1,142.43	$1,384.59	$1,883.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $749.18 / $749.18 / $6,207.91	Facility		$749.18	$749.18	$6,207.91
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.45 / $74.45 / $74.45	Facility	AS	$74.45	$74.45	$74.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $723.04 / $1,107.40 / $1,677.99	Professional		$723.04	$1,107.40	$1,677.99
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,955.22 / $1,955.22 / $1,955.22	Professional	22	$1,955.22	$1,955.22	$1,955.22
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $52.14 / $52.14 / $52.14	Professional	80	$52.14	$52.14	$52.14
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $26.07 / $26.07 / $26.07	Professional	AS	$26.07	$26.07	$26.07
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