Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $860.16 / $4,592.00 / $12,750.00	Facility		$860.16	$4,592.00	$12,750.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $580.00 / $2,889.99 / $12,926.58	Facility		$580.00	$2,889.99	$12,926.58
CareSource Facility/Professional Facility Modifier Low / Median / High Price $860.79 / $860.79 / $860.79	Facility		$860.79	$860.79	$860.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $486.62 / $731.00 / $4,141.20	Facility		$486.62	$731.00	$4,141.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $415.16 / $539.71 / $1,431.46	Professional		$415.16	$539.71	$1,431.46
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,166.32 / $1,166.32 / $1,488.78	Professional	22	$1,166.32	$1,166.32	$1,488.78
United Facility/Professional Facility Modifier Low / Median / High Price $576.00 / $3,895.00 / $12,192.00	Facility		$576.00	$3,895.00	$12,192.00