Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $5,623.41 / $9,549.93	Facility		$2,884.03	$5,623.41	$9,549.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,230.27 / $3,162.28 / $6,025.60	Facility		$1,230.27	$3,162.28	$6,025.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $2,089.30 / $2,511.89	Facility		$501.19	$2,089.30	$2,511.89
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility	22	$2,511.89	$2,511.89	$2,511.89
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility	54	$1,445.44	$1,445.44	$1,445.44
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	AS	$208.93	$208.93	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,862.09 / $6,760.83	Professional		$1,258.93	$1,862.09	$6,760.83
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Professional	22	$3,630.78	$3,630.78	$3,630.78
Kaiser Permanente Facility/Professional Professional Modifier 54 Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Professional	54	$1,698.24	$1,698.24	$1,698.24
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	80	$97.72	$97.72	$97.72
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $47.86 / $47.86 / $47.86	Professional	AS	$47.86	$47.86	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $6,456.54 / $12,022.64	Facility		$1,737.80	$6,456.54	$12,022.64