Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,804.83 / $5,045.00 / $6,915.00	Facility		$1,804.83	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,732.27 / $6,959.71 / $17,687.80	Facility		$1,732.27	$6,959.71	$17,687.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $3,097.32 / $3,411.71 / $5,239.39	Facility		$3,097.32	$3,411.71	$5,239.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,622.51 / $2,109.26 / $2,880.69	Professional		$1,622.51	$2,109.26	$2,880.69
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,887.87 / $3,887.87 / $3,887.87	Professional	22	$3,887.87	$3,887.87	$3,887.87
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $103.68 / $103.68 / $103.68	Professional	80	$103.68	$103.68	$103.68
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $51.84 / $51.84 / $51.84	Professional	AS	$51.84	$51.84	$51.84
United Facility/Professional Facility Modifier Low / Median / High Price $2,303.00 / $10,133.00 / $20,037.00	Facility		$2,303.00	$10,133.00	$20,037.00