Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,656.46 / $7,045.00 / $24,251.60	Facility		$2,656.46	$7,045.00	$24,251.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $978.56 / $1,377.17 / $1,791.11	Facility	52	$978.56	$1,377.17	$1,791.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,361.69 / $16,871.20 / $47,597.80	Facility		$2,361.69	$16,871.20	$47,597.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,325.14 / $3,964.62 / $5,393.04	Facility		$3,325.14	$3,964.62	$5,393.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,155.96 / $52,000.00	Facility		$500.00	$2,155.96	$52,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,701.26 / $1,701.26 / $1,701.26	Facility	52	$1,701.26	$1,701.26	$1,701.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $212.66 / $212.66 / $212.66	Facility	AS	$212.66	$212.66	$212.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,070.35 / $3,025.01 / $10,541.25	Professional		$2,070.35	$3,025.01	$10,541.25
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $8,242.37 / $8,242.37 / $8,242.37	Professional	22	$8,242.37	$8,242.37	$8,242.37
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $2,404.03 / $2,404.03 / $2,404.03	Professional	52	$2,404.03	$2,404.03	$2,404.03
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $219.80 / $219.80 / $219.80	Professional	80	$219.80	$219.80	$219.80
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $109.90 / $109.90 / $109.90	Professional	AS	$109.90	$109.90	$109.90
United Facility/Professional Facility Modifier Low / Median / High Price $2,908.00 / $16,710.00 / $28,629.00	Facility		$2,908.00	$16,710.00	$28,629.00