Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,500.00 / $6,439.00 / $17,192.00	Facility		$2,500.00	$6,439.00	$17,192.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $782.65 / $1,090.96 / $1,418.50	Facility	52	$782.65	$1,090.96	$1,418.50
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 $2,659.25 / $3,176.21 / $4,320.57	Facility		$2,659.25	$3,176.21	$4,320.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,723.69 / $52,000.00	Facility		$500.00	$1,723.69	$52,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,362.43 / $1,362.43 / $1,362.43	Facility	52	$1,362.43	$1,362.43	$1,362.43
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $170.30 / $170.30 / $170.30	Facility	AS	$170.30	$170.30	$170.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,658.64 / $2,414.73 / $8,430.91	Professional		$1,658.64	$2,414.73	$8,430.91
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,485.25 / $4,485.25 / $4,485.25	Professional	22	$4,485.25	$4,485.25	$4,485.25
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,308.20 / $1,308.20 / $1,308.20	Professional	52	$1,308.20	$1,308.20	$1,308.20
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $119.61 / $119.61 / $119.61	Professional	80	$119.61	$119.61	$119.61
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $59.80 / $59.80 / $59.80	Professional	AS	$59.80	$59.80	$59.80
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