Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,814.29 / $5,045.00 / $6,915.00	Facility		$1,814.29	$5,045.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $907.15 / $1,161.15 / $1,727.92	Facility	52	$907.15	$1,161.15	$1,727.92
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 $2,499.73 / $2,499.73 / $2,499.73	Facility		$2,499.73	$2,499.73	$2,499.73
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 52 Low / Median / High Price $1,615.65 / $1,615.65 / $1,615.65	Facility	52	$1,615.65	$1,615.65	$1,615.65
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $201.96 / $201.96 / $201.96	Facility	AS	$201.96	$201.96	$201.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,782.45 / $2,317.19 / $4,127.60	Professional		$1,782.45	$2,317.19	$4,127.60
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,007.47 / $5,007.47 / $6,391.90	Professional	22	$5,007.47	$5,007.47	$6,391.90
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,460.51 / $1,460.51 / $1,864.30	Professional	52	$1,460.51	$1,460.51	$1,864.30
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $133.53 / $133.53 / $170.45	Professional	80	$133.53	$133.53	$170.45
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $66.77 / $66.77 / $85.23	Professional	AS	$66.77	$66.77	$85.23
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