Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,814.70 / $5,454.83 / $14,497.00	Facility		$1,814.70	$5,454.83	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $610.00 / $3,801.18 / $23,000.53	Facility		$610.00	$3,801.18	$23,000.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,400.37 / $1,400.37 / $1,400.37	Facility		$1,400.37	$1,400.37	$1,400.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $518.00 / $2,123.07 / $9,353.00	Facility		$518.00	$2,123.07	$9,353.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $107.75 / $107.75 / $107.75	Facility	AS	$107.75	$107.75	$107.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $956.90 / $1,243.97 / $2,623.35	Professional		$956.90	$1,243.97	$2,623.35
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,688.24 / $2,688.24 / $3,431.46	Professional	22	$2,688.24	$2,688.24	$3,431.46
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $71.69 / $71.69 / $91.51	Professional	80	$71.69	$71.69	$91.51
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $35.84 / $35.84 / $45.75	Professional	AS	$35.84	$35.84	$45.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,049.00 / $8,566.00 / $25,148.00	Facility		$1,049.00	$8,566.00	$25,148.00