Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $964.96 / $4,126.00 / $6,915.00	Facility		$964.96	$4,126.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,206.01 / $5,435.54 / $12,227.65	Facility		$1,206.01	$5,435.54	$12,227.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,250.43 / $1,505.82 / $2,048.37	Facility		$1,250.43	$1,505.82	$2,048.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $815.76 / $815.76 / $6,109.56	Facility		$815.76	$815.76	$6,109.56
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.87 / $80.87 / $80.87	Facility	AS	$80.87	$80.87	$80.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $786.35 / $1,114.58 / $2,106.69	Professional		$786.35	$1,114.58	$2,106.69
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $56.70 / $56.70 / $56.70	Professional	80	$56.70	$56.70	$56.70
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.35 / $28.35 / $28.35	Professional	AS	$28.35	$28.35	$28.35
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