Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,458.36 / $7,815.00 / $23,207.90	Facility		$2,458.36	$7,815.00	$23,207.90
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $722.00 / $1,265.48 / $11,030.00	Facility	52	$722.00	$1,265.48	$11,030.00
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 $2,451.98 / $2,936.58 / $3,994.62	Facility		$2,451.98	$2,936.58	$3,994.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,589.74 / $52,000.00	Facility		$500.00	$1,589.74	$52,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,259.83 / $1,259.83 / $1,259.83	Facility	52	$1,259.83	$1,259.83	$1,259.83
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $157.47 / $157.47 / $157.47	Facility	AS	$157.47	$157.47	$157.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,533.51 / $2,230.56 / $7,777.57	Professional		$1,533.51	$2,230.56	$7,777.57
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,146.89 / $4,146.89 / $4,146.89	Professional	22	$4,146.89	$4,146.89	$4,146.89
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,209.51 / $1,209.51 / $1,209.51	Professional	52	$1,209.51	$1,209.51	$1,209.51
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $110.58 / $110.58 / $110.58	Professional	80	$110.58	$110.58	$110.58
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $55.29 / $55.29 / $55.29	Professional	AS	$55.29	$55.29	$55.29
United Facility/Professional Facility Modifier Low / Median / High Price $2,908.00 / $14,950.00 / $28,629.00	Facility		$2,908.00	$14,950.00	$28,629.00