Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $703.44 / $5,045.00 / $6,915.00	Facility		$703.44	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $572.89 / $2,155.98 / $4,875.60	Facility		$572.89	$2,155.98	$4,875.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $988.60 / $988.60 / $988.60	Facility		$988.60	$988.60	$988.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $835.00	Facility		$200.00	$617.00	$835.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $79.00 / $79.00 / $79.00	Facility	AS	$79.00	$79.00	$79.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $698.83 / $908.48 / $1,610.52	Professional		$698.83	$908.48	$1,610.52
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,926.52 / $3,926.52 / $5,231.52	Professional	22	$3,926.52	$3,926.52	$5,231.52
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $104.71 / $104.71 / $139.51	Professional	80	$104.71	$104.71	$139.51
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $52.35 / $52.35 / $69.75	Professional	AS	$52.35	$52.35	$69.75
United Facility/Professional Facility Modifier Low / Median / High Price $576.00 / $3,895.00 / $6,995.00	Facility		$576.00	$3,895.00	$6,995.00