Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,925.00 / $5,063.00 / $6,915.00	Facility		$1,925.00	$5,063.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,282.27 / $4,288.46 / $8,685.00	Facility		$1,282.27	$4,288.46	$8,685.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,780.57 / $3,325.67 / $4,523.89	Facility		$2,780.57	$3,325.67	$4,523.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,802.76 / $2,500.00	Facility		$500.00	$1,802.76	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $178.36 / $178.36 / $178.36	Facility	AS	$178.36	$178.36	$178.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,736.69 / $2,517.80 / $5,761.71	Professional		$1,736.69	$2,517.80	$5,761.71
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $6,914.05 / $6,914.05 / $6,914.05	Professional	22	$6,914.05	$6,914.05	$6,914.05
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $184.37 / $184.37 / $184.37	Professional	80	$184.37	$184.37	$184.37
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $92.19 / $92.19 / $92.19	Professional	AS	$92.19	$92.19	$92.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00