Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,374.00 / $5,063.00 / $7,421.00	Facility		$1,374.00	$5,063.00	$7,421.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,336.91 / $4,431.64 / $21,657.35	Facility		$1,336.91	$4,431.64	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,155.59 / $2,574.54 / $3,502.14	Facility		$2,155.59	$2,574.54	$3,502.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,399.57 / $2,500.00	Facility		$500.00	$1,399.57	$2,500.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $138.28 / $138.28 / $138.28	Facility	AS	$138.28	$138.28	$138.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,344.44 / $1,955.69 / $3,697.93	Professional		$1,344.44	$1,955.69	$3,697.93
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,635.60 / $3,635.60 / $3,635.60	Professional	22	$3,635.60	$3,635.60	$3,635.60
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $96.95 / $96.95 / $96.95	Professional	80	$96.95	$96.95	$96.95
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $48.47 / $48.47 / $48.47	Professional	AS	$48.47	$48.47	$48.47
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