Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,654.27 / $4,733.00 / $6,915.00	Facility		$1,654.27	$4,733.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $827.14 / $1,151.03 / $1,575.83	Facility	52	$827.14	$1,151.03	$1,575.83
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 $2,412.58 / $2,412.58 / $2,412.58	Facility		$2,412.58	$2,412.58	$2,412.58
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 $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $183.95	Facility	AS	$183.95	$183.95	$183.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,626.50 / $2,114.44 / $3,807.82	Professional		$1,626.50	$2,114.44	$3,807.82
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,569.38 / $4,569.38 / $5,832.68	Professional	22	$4,569.38	$4,569.38	$5,832.68
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,332.74 / $1,332.74 / $1,701.20	Professional	52	$1,332.74	$1,332.74	$1,701.20
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $121.85 / $121.85 / $155.54	Professional	80	$121.85	$121.85	$155.54
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.93 / $60.93 / $77.77	Professional	AS	$60.93	$60.93	$77.77
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