Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,791.00 / $5,175.00 / $14,490.00	Facility		$1,791.00	$5,175.00	$14,490.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,361.69 / $10,704.09 / $23,169.33	Facility		$2,361.69	$10,704.09	$23,169.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,095.77 / $2,465.61 / $3,421.11	Facility		$2,095.77	$2,465.61	$3,421.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,360.16 / $2,500.00	Facility		$500.00	$1,360.16	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $135.00 / $135.00 / $135.00	Facility	AS	$135.00	$135.00	$135.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,313.33 / $1,891.72 / $4,357.14	Professional		$1,313.33	$1,891.72	$4,357.14
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,228.57 / $5,228.57 / $5,228.57	Professional	22	$5,228.57	$5,228.57	$5,228.57
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $139.43 / $139.43 / $139.43	Professional	80	$139.43	$139.43	$139.43
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $69.70 / $69.70 / $69.70	Professional	AS	$69.70	$69.70	$69.70
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00