Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,001.78 / $4,829.00 / $6,915.00	Facility		$1,001.78	$4,829.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,402.00 / $5,435.54 / $12,227.65	Facility		$1,402.00	$5,435.54	$12,227.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,112.58 / $1,342.31 / $1,825.92	Facility		$1,112.58	$1,342.31	$1,825.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $727.61 / $727.61 / $4,830.16	Facility		$727.61	$727.61	$4,830.16
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $72.09 / $72.09 / $72.09	Facility	AS	$72.09	$72.09	$72.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $700.96 / $997.06 / $1,579.62	Professional		$700.96	$997.06	$1,579.62
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $50.55 / $50.55 / $50.55	Professional	80	$50.55	$50.55	$50.55
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $25.27 / $25.27 / $25.27	Professional	AS	$25.27	$25.27	$25.27
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