Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $453.56 / $4,733.00 / $7,233.60	Facility		$453.56	$4,733.00	$7,233.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $107.38 / $107.38 / $226.78	Facility	52	$107.38	$107.38	$226.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $722.00 / $3,142.00 / $8,028.57	Facility		$722.00	$3,142.00	$8,028.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $294.44 / $294.44 / $294.44	Facility		$294.44	$294.44	$294.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.00 / $703.00 / $5,320.55	Facility		$506.00	$703.00	$5,320.55
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $191.49 / $191.49 / $191.49	Facility	52	$191.49	$191.49	$191.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.27 / $273.35 / $993.00	Professional		$210.27	$273.35	$993.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $590.72 / $590.72 / $754.06	Professional	22	$590.72	$590.72	$754.06
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $172.29 / $172.29 / $219.93	Professional	52	$172.29	$172.29	$219.93
United Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $4,666.00 / $8,554.00	Facility		$651.00	$4,666.00	$8,554.00