Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,188.00 / $9,499.00 / $14,497.00	Facility		$4,188.00	$9,499.00	$14,497.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $314.95 / $584.84 / $806.21	Facility	52	$314.95	$584.84	$806.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,931.00 / $6,045.77 / $14,877.94	Facility		$1,931.00	$6,045.77	$14,877.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $649.22 / $876.01 / $969.87	Facility		$649.22	$876.01	$969.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,008.00 / $7,258.00 / $10,047.00	Facility		$5,008.00	$7,258.00	$10,047.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $649.22 / $843.99 / $2,277.21	Professional		$649.22	$843.99	$2,277.21
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,695.12 / $1,695.12 / $1,695.12	Professional	22	$1,695.12	$1,695.12	$1,695.12
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $494.41 / $494.41 / $494.41	Professional	52	$494.41	$494.41	$494.41
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $45.20 / $45.20 / $45.20	Professional	80	$45.20	$45.20	$45.20
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $22.60 / $22.60 / $22.60	Professional	AS	$22.60	$22.60	$22.60
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