Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,024.61 / $6,319.00 / $17,192.00	Facility		$2,024.61	$6,319.00	$17,192.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,226.13 / $9,454.90 / $32,952.16	Facility		$2,226.13	$9,454.90	$32,952.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,005.23 / $2,403.23 / $3,269.12	Facility		$2,005.23	$2,403.23	$3,269.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,300.96 / $12,495.14 / $52,000.00	Facility		$1,300.96	$12,495.14	$52,000.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $128.96 / $128.96 / $128.96	Facility	AS	$128.96	$128.96	$128.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,254.99 / $1,827.89 / $3,439.38	Professional		$1,254.99	$1,827.89	$3,439.38
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,393.72 / $3,393.72 / $3,393.72	Professional	22	$3,393.72	$3,393.72	$3,393.72
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $90.50 / $90.50 / $90.50	Professional	80	$90.50	$90.50	$90.50
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $45.25 / $45.25 / $45.25	Professional	AS	$45.25	$45.25	$45.25
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