Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,853.97 / $8,180.00 / $23,248.14	Facility		$2,853.97	$8,180.00	$23,248.14
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $900.69 / $1,249.83 / $1,625.18	Facility	52	$900.69	$1,249.83	$1,625.18
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 $3,058.85 / $3,655.19 / $4,972.14	Facility		$3,058.85	$3,655.19	$4,972.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,984.25 / $52,000.00	Facility		$500.00	$1,984.25	$52,000.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,569.13 / $1,569.13 / $1,569.13	Facility	52	$1,569.13	$1,569.13	$1,569.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $196.14 / $196.14 / $196.14	Facility	AS	$196.14	$196.14	$196.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,908.76 / $2,776.38 / $9,702.40	Professional		$1,908.76	$2,776.38	$9,702.40
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $7,599.08 / $7,599.08 / $7,599.08	Professional	22	$7,599.08	$7,599.08	$7,599.08
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $2,216.40 / $2,216.40 / $2,216.40	Professional	52	$2,216.40	$2,216.40	$2,216.40
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $202.64 / $202.64 / $202.64	Professional	80	$202.64	$202.64	$202.64
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $101.32 / $101.32 / $101.32	Professional	AS	$101.32	$101.32	$101.32
United Facility/Professional Facility Modifier Low / Median / High Price $3,800.00 / $10,789.00 / $24,153.00	Facility		$3,800.00	$10,789.00	$24,153.00