Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $628.83 / $4,592.00 / $6,915.00	Facility		$628.83	$4,592.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,082.02 / $3,088.55 / $6,315.83	Facility		$1,082.02	$3,088.55	$6,315.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $737.90 / $890.31 / $1,211.09	Facility		$737.90	$890.31	$1,211.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.15 / $724.15 / $2,172.58	Facility		$724.15	$724.15	$2,172.58
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $72.42 / $72.42 / $72.42	Facility	AS	$72.42	$72.42	$72.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $507.20 / $739.67 / $1,468.21	Professional		$507.20	$739.67	$1,468.21
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $33.53 / $33.53 / $46.98	Professional	80	$33.53	$33.53	$46.98
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $16.76 / $16.76 / $23.49	Professional	AS	$16.76	$16.76	$23.49
United Facility/Professional Facility Modifier Low / Median / High Price $1,075.00 / $4,826.00 / $7,889.00	Facility		$1,075.00	$4,826.00	$7,889.00