Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,458.88 / $5,595.00 / $9,512.00	Facility		$1,458.88	$5,595.00	$9,512.00
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 $1,591.76 / $1,591.76 / $1,591.76	Facility		$1,591.76	$1,591.76	$1,591.76
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 $121.95 / $121.95 / $121.95	Facility	AS	$121.95	$121.95	$121.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,081.21 / $1,405.57 / $2,531.21	Professional		$1,081.21	$1,405.57	$2,531.21
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,037.46 / $3,037.46 / $3,877.25	Professional	22	$3,037.46	$3,037.46	$3,877.25
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $81.00 / $81.00 / $103.39	Professional	80	$81.00	$81.00	$103.39
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $40.50 / $40.50 / $51.70	Professional	AS	$40.50	$40.50	$51.70
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