Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,142.63 / $5,664.00 / $11,021.92	Facility		$2,142.63	$5,664.00	$11,021.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,282.27 / $5,155.99 / $21,657.35	Facility		$1,282.27	$5,155.99	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,334.98 / $2,801.64 / $3,811.05	Facility		$2,334.98	$2,801.64	$3,811.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,515.50 / $2,500.00	Facility		$500.00	$1,515.50	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $150.40 / $150.40 / $150.40	Facility	AS	$150.40	$150.40	$150.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,463.03 / $2,108.71 / $3,706.43	Professional		$1,463.03	$2,108.71	$3,706.43
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,956.30 / $3,956.30 / $3,956.30	Professional	22	$3,956.30	$3,956.30	$3,956.30
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $105.50 / $105.50 / $105.50	Professional	80	$105.50	$105.50	$105.50
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $52.75 / $52.75 / $52.75	Professional	AS	$52.75	$52.75	$52.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $7,794.00 / $14,048.00	Facility		$1,738.00	$7,794.00	$14,048.00