Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $239.39 / $5,045.00 / $6,915.00	Facility		$239.39	$5,045.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $119.70 / $196.42 / $348.70	Facility	52	$119.70	$196.42	$348.70
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 $377.47 / $377.47 / $377.47	Facility		$377.47	$377.47	$377.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.00 / $617.00 / $835.00	Facility		$506.00	$617.00	$835.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $26.66	Facility	AS	$26.66	$26.66	$26.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $236.07 / $306.89 / $901.36	Professional		$236.07	$306.89	$901.36
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $193.43 / $193.43 / $246.90	Professional	52	$193.43	$193.43	$246.90
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $17.68 / $17.68 / $22.57	Professional	80	$17.68	$17.68	$22.57
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $8.84 / $8.84 / $11.29	Professional	AS	$8.84	$8.84	$11.29
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