Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,116.18 / $5,063.00 / $15,301.00	Facility		$1,116.18	$5,063.00	$15,301.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $5,634.28 / $21,112.96	Facility		$1,206.01	$5,634.28	$21,112.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,046.75 / $1,276.49 / $1,736.40	Facility		$1,046.75	$1,276.49	$1,736.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $691.52 / $691.52 / $4,830.16	Facility		$691.52	$691.52	$4,830.16
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $69.08 / $69.08 / $69.08	Facility	AS	$69.08	$69.08	$69.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $666.60 / $957.00 / $1,706.53	Professional		$666.60	$957.00	$1,706.53
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,802.58 / $1,802.58 / $1,802.58	Professional	22	$1,802.58	$1,802.58	$1,802.58
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $48.07 / $48.07 / $48.07	Professional	80	$48.07	$48.07	$48.07
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $24.03 / $24.03 / $24.03	Professional	AS	$24.03	$24.03	$24.03
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,351.00 / $8,836.00	Facility		$1,519.00	$6,351.00	$8,836.00