Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $440.00 / $2,950.00 / $6,858.00	Facility		$440.00	$2,950.00	$6,858.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.82 / $176.92 / $315.91	Facility	52	$98.82	$176.92	$315.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.53 / $70.77 / $126.36	Facility	53	$39.53	$70.77	$126.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $568.00 / $2,081.07 / $4,819.75	Facility		$568.00	$2,081.07	$4,819.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $377.16 / $377.16 / $377.16	Facility		$377.16	$377.16	$377.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $448.00 / $715.00 / $1,091.58	Facility		$448.00	$715.00	$1,091.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.24 / $252.51 / $816.59	Professional		$194.24	$252.51	$816.59
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $159.15 / $159.15 / $203.15	Professional	52	$159.15	$159.15	$203.15
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $159.15 / $159.15 / $264.10	Professional	53	$159.15	$159.15	$264.10
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $170.52 / $170.52 / $217.67	Professional	62	$170.52	$170.52	$217.67
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $14.55 / $14.55 / $18.57	Professional	80	$14.55	$14.55	$18.57
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $7.28 / $7.28 / $9.28	Professional	AS	$7.28	$7.28	$9.28
United Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $2,307.00 / $5,272.00	Facility		$515.00	$2,307.00	$5,272.00