Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,010.85 / $7,045.00 / $14,497.00	Facility		$1,010.85	$7,045.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,267.00 / $4,124.72 / $9,026.11	Facility		$1,267.00	$4,124.72	$9,026.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $795.02 / $795.02 / $795.02	Facility		$795.02	$795.02	$795.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $657.10 / $3,237.36 / $9,829.00	Facility		$657.10	$3,237.36	$9,829.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $65.17 / $65.17 / $65.17	Facility	AS	$65.17	$65.17	$65.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $577.44 / $750.67 / $1,351.86	Professional		$577.44	$750.67	$1,351.86
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,622.23 / $1,622.23 / $2,070.71	Professional	22	$1,622.23	$1,622.23	$2,070.71
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $43.26 / $43.26 / $55.22	Professional	80	$43.26	$43.26	$55.22
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $21.63 / $21.63 / $27.61	Professional	AS	$21.63	$21.63	$27.61
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