Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,021.91 / $5,045.00 / $6,915.00	Facility		$2,021.91	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,801.18 / $10,304.31	Facility		$659.95	$3,801.18	$10,304.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,790.41 / $2,790.41 / $2,790.41	Facility		$2,790.41	$2,790.41	$2,790.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,233.00	Facility		$200.00	$617.00	$1,233.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $227.05 / $227.05 / $227.05	Facility	AS	$227.05	$227.05	$227.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,015.32 / $2,619.92 / $4,610.93	Professional		$2,015.32	$2,619.92	$4,610.93
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,661.72 / $5,661.72 / $7,227.00	Professional	22	$5,661.72	$5,661.72	$7,227.00
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $150.97 / $150.97 / $192.72	Professional	80	$150.97	$150.97	$192.72
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $75.48 / $75.48 / $96.36	Professional	AS	$75.48	$75.48	$96.36
United Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $2,969.00 / $9,079.00	Facility		$400.00	$2,969.00	$9,079.00