Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,622.52 / $4,852.00 / $10,000.00	Facility		$1,622.52	$4,852.00	$10,000.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,603.22 / $5,435.54 / $12,227.65	Facility		$1,603.22	$5,435.54	$12,227.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,103.85 / $1,528.45 / $2,612.23	Facility		$1,103.85	$1,528.45	$2,612.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,200.77 / $1,200.77 / $6,589.65	Facility		$1,200.77	$1,200.77	$6,589.65
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $119.08 / $119.08 / $119.08	Facility	AS	$119.08	$119.08	$119.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,159.51 / $1,775.90 / $2,843.54	Professional		$1,159.51	$1,775.90	$2,843.54
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,135.53 / $3,135.53 / $3,135.53	Professional	22	$3,135.53	$3,135.53	$3,135.53
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $83.61 / $83.61 / $83.61	Professional	80	$83.61	$83.61	$83.61
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $41.81 / $41.81 / $41.81	Professional	AS	$41.81	$41.81	$41.81
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,409.00 / $5,409.00 / $13,322.92	Facility		$5,409.00	$5,409.00	$13,322.92
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