Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $946.42 / $5,045.00 / $8,331.00	Facility		$946.42	$5,045.00	$8,331.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,226.13 / $6,105.48 / $13,137.87	Facility		$2,226.13	$6,105.48	$13,137.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,628.03 / $1,785.12 / $2,741.45	Facility		$1,628.03	$1,785.12	$2,741.45
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 $852.83 / $1,108.68 / $4,229.00	Professional		$852.83	$1,108.68	$4,229.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,043.55 / $2,043.55 / $2,043.55	Professional	22	$2,043.55	$2,043.55	$2,043.55
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $54.49 / $54.49 / $54.49	Professional	80	$54.49	$54.49	$54.49
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $27.25 / $27.25 / $27.25	Professional	AS	$27.25	$27.25	$27.25
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,629.00 / $10,000.00	Facility		$607.00	$3,629.00	$10,000.00