Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $5,623.41 / $9,549.93	Facility		$2,187.76	$5,623.41	$9,549.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $3,162.28 / $6,760.83	Facility		$851.14	$3,162.28	$6,760.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $616.60 / $831.76	Facility		$501.19	$616.60	$831.76
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,698.24 / $3,235.94	Professional		$1,288.25	$1,698.24	$3,235.94
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,715.35 / $3,715.35 / $4,786.30	Professional	22	$3,715.35	$3,715.35	$4,786.30
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,096.48 / $1,096.48 / $1,380.38	Professional	52	$1,096.48	$1,096.48	$1,380.38
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $100.00 / $100.00 / $125.89	Professional	80	$100.00	$100.00	$125.89
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $50.12 / $50.12 / $63.10	Professional	AS	$50.12	$50.12	$63.10
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $2,511.89 / $7,079.46	Facility		$398.11	$2,511.89	$7,079.46