Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,514.00 / $4,592.00 / $6,915.00	Facility		$1,514.00	$4,592.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,402.00 / $5,625.09 / $13,137.87	Facility		$1,402.00	$5,625.09	$13,137.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,757.67 / $2,106.87 / $2,865.96	Facility		$1,757.67	$2,106.87	$2,865.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,145.58 / $1,145.58 / $13,192.76	Facility		$1,145.58	$1,145.58	$13,192.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $113.45 / $113.45 / $113.45	Facility	AS	$113.45	$113.45	$113.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,100.22 / $1,622.24 / $2,670.83	Professional		$1,100.22	$1,622.24	$2,670.83
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,975.21 / $2,975.21 / $2,975.21	Professional	22	$2,975.21	$2,975.21	$2,975.21
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $79.34 / $79.34 / $79.34	Professional	80	$79.34	$79.34	$79.34
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $39.67 / $39.67 / $39.67	Professional	AS	$39.67	$39.67	$39.67
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00