Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,275.00 / $8,655.65 / $14,497.00	Facility		$4,275.00	$8,655.65	$14,497.00
Aetna Facility/Professional Facility Modifier 62 Low / Median / High Price $2,386.98 / $2,386.98 / $2,386.98	Facility	62	$2,386.98	$2,386.98	$2,386.98
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 $2,174.66 / $2,174.66 / $2,174.66	Facility		$2,174.66	$2,174.66	$2,174.66
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 $1,205.60 / $1,205.60 / $1,205.60	Facility	62	$1,205.60	$1,205.60	$1,205.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $192.90 / $192.90 / $192.90	Facility	AS	$192.90	$192.90	$192.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,710.51 / $2,223.66 / $7,989.00	Professional		$1,710.51	$2,223.66	$7,989.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,805.39 / $4,805.39 / $6,133.94	Professional	22	$4,805.39	$4,805.39	$6,133.94
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,501.69 / $1,501.69 / $1,916.86	Professional	62	$1,501.69	$1,501.69	$1,916.86
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $128.13 / $128.13 / $163.57	Professional	80	$128.13	$128.13	$163.57
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $64.06 / $64.06 / $81.79	Professional	AS	$64.06	$64.06	$81.79
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