Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,135.75 / $8,739.96 / $14,497.00	Facility		$4,135.75	$8,739.96	$14,497.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $12,902.00 / $12,902.00 / $12,902.00	Facility	22	$12,902.00	$12,902.00	$12,902.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,088.00 / $4,789.00 / $13,137.87	Facility		$1,088.00	$4,789.00	$13,137.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,932.71 / $1,932.71 / $1,932.71	Facility		$1,932.71	$1,932.71	$1,932.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $703.00 / $9,852.00	Facility		$400.00	$703.00	$9,852.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,070.46 / $1,070.46 / $1,070.46	Facility	62	$1,070.46	$1,070.46	$1,070.46
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $171.27 / $171.27 / $171.27	Facility	AS	$171.27	$171.27	$171.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,517.42 / $1,972.65 / $6,256.00	Professional		$1,517.42	$1,972.65	$6,256.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,262.93 / $4,262.93 / $5,441.52	Professional	22	$4,262.93	$4,262.93	$5,441.52
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,332.17 / $1,332.17 / $1,700.48	Professional	62	$1,332.17	$1,332.17	$1,700.48
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $113.68 / $113.68 / $145.11	Professional	80	$113.68	$113.68	$145.11
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $56.84 / $56.84 / $72.55	Professional	AS	$56.84	$56.84	$72.55
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