Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,424.19 / $6,900.00 / $19,318.00	Facility		$2,424.19	$6,900.00	$19,318.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $753.37 / $1,048.31 / $1,362.29	Facility	52	$753.37	$1,048.31	$1,362.29
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 $2,559.35 / $3,058.07 / $4,159.85	Facility		$2,559.35	$3,058.07	$4,159.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,659.29 / $52,000.00	Facility		$500.00	$1,659.29	$52,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,312.03 / $1,312.03 / $1,312.03	Facility	52	$1,312.03	$1,312.03	$1,312.03
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $164.00 / $164.00 / $164.00	Facility	AS	$164.00	$164.00	$164.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,596.94 / $2,324.57 / $8,115.50	Professional		$1,596.94	$2,324.57	$8,115.50
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,318.39 / $4,318.39 / $4,318.39	Professional	22	$4,318.39	$4,318.39	$4,318.39
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,259.53 / $1,259.53 / $1,259.53	Professional	52	$1,259.53	$1,259.53	$1,259.53
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $115.16 / $115.16 / $115.16	Professional	80	$115.16	$115.16	$115.16
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $57.58 / $57.58 / $57.58	Professional	AS	$57.58	$57.58	$57.58
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