Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,458.00 / $5,045.00 / $6,915.00	Facility		$1,458.00	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,318.35 / $4,431.64 / $21,657.35	Facility		$1,318.35	$4,431.64	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,692.20 / $2,027.75 / $2,758.32	Facility		$1,692.20	$2,027.75	$2,758.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,096.91 / $2,500.00	Facility		$500.00	$1,096.91	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $108.71 / $108.71 / $108.71	Facility	AS	$108.71	$108.71	$108.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,058.90 / $1,532.59 / $3,041.73	Professional		$1,058.90	$1,532.59	$3,041.73
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,863.46 / $2,863.46 / $2,863.46	Professional	22	$2,863.46	$2,863.46	$2,863.46
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $76.36 / $76.36 / $76.36	Professional	80	$76.36	$76.36	$76.36
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $38.18 / $38.18 / $38.18	Professional	AS	$38.18	$38.18	$38.18
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