Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,355.14 / $5,045.00 / $6,915.00	Facility		$1,355.14	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,862.88 / $17,381.29	Facility		$659.95	$3,862.88	$17,381.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,864.82 / $1,864.82 / $1,864.82	Facility		$1,864.82	$1,864.82	$1,864.82
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 $152.11 / $152.11 / $152.11	Facility	AS	$152.11	$152.11	$152.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,349.51 / $1,754.36 / $3,078.56	Professional		$1,349.51	$1,754.36	$3,078.56
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,791.21 / $3,791.21 / $4,839.37	Professional	22	$3,791.21	$3,791.21	$4,839.37
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $101.10 / $101.10 / $129.05	Professional	80	$101.10	$101.10	$129.05
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $50.55 / $50.55 / $64.52	Professional	AS	$50.55	$50.55	$64.52
United Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $4,666.00 / $8,554.00	Facility		$651.00	$4,666.00	$8,554.00