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 $1,737.66 / $2,079.80 / $2,829.14	Facility		$1,737.66	$2,079.80	$2,829.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,129.30 / $2,500.00	Facility		$500.00	$1,129.30	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $111.81 / $111.81 / $111.81	Facility	AS	$111.81	$111.81	$111.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,086.09 / $1,571.66 / $3,005.05	Professional		$1,086.09	$1,571.66	$3,005.05
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,936.98 / $2,936.98 / $2,936.98	Professional	22	$2,936.98	$2,936.98	$2,936.98
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $78.31 / $78.31 / $78.31	Professional	80	$78.31	$78.31	$78.31
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $39.15 / $39.15 / $39.15	Professional	AS	$39.15	$39.15	$39.15
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