Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,978.50 / $4,829.00 / $7,268.00	Facility		$1,978.50	$4,829.00	$7,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,126.00 / $4,353.00 / $4,542.00	Facility	50	$4,126.00	$4,353.00	$4,542.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $685.47 / $948.87 / $1,261.29	Facility	52	$685.47	$948.87	$1,261.29
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 $2,727.66 / $2,968.77 / $4,559.18	Facility		$2,727.66	$2,968.77	$4,559.18
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 $1,428.87 / $1,857.53 / $2,877.61	Professional		$1,428.87	$1,857.53	$2,877.61
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,730.82 / $3,730.82 / $3,730.82	Professional	22	$3,730.82	$3,730.82	$3,730.82
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,088.16 / $1,088.16 / $1,088.16	Professional	52	$1,088.16	$1,088.16	$1,088.16
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,165.88 / $1,165.88 / $1,165.88	Professional	62	$1,165.88	$1,165.88	$1,165.88
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $99.49 / $99.49 / $99.49	Professional	80	$99.49	$99.49	$99.49
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $49.74 / $49.74 / $49.74	Professional	AS	$49.74	$49.74	$49.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,826.00 / $7,889.00	Facility		$1,200.00	$4,826.00	$7,889.00