Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,921.46 / $6,760.00 / $14,497.00	Facility		$1,921.46	$6,760.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,275.00 / $4,607.43 / $14,315.61	Facility		$1,275.00	$4,607.43	$14,315.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,602.71 / $1,602.71 / $1,602.71	Facility		$1,602.71	$1,602.71	$1,602.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $988.00 / $9,852.00	Facility		$400.00	$988.00	$9,852.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $120.50 / $120.50 / $120.50	Facility	AS	$120.50	$120.50	$120.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,068.60 / $1,389.19 / $2,552.75	Professional		$1,068.60	$1,389.19	$2,552.75
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,002.09 / $3,002.09 / $3,832.08	Professional	22	$3,002.09	$3,002.09	$3,832.08
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $80.06 / $80.06 / $102.19	Professional	80	$80.06	$80.06	$102.19
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $40.03 / $40.03 / $51.09	Professional	AS	$40.03	$40.03	$51.09
United Facility/Professional Facility Modifier Low / Median / High Price $851.00 / $6,868.00 / $16,000.00	Facility		$851.00	$6,868.00	$16,000.00