Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,638.24 / $5,045.00 / $6,915.00	Facility		$1,638.24	$5,045.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $819.12 / $1,299.54 / $1,569.84	Facility	52	$819.12	$1,299.54	$1,569.84
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 $2,469.96 / $2,469.96 / $2,469.96	Facility		$2,469.96	$2,469.96	$2,469.96
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 $1,468.02 / $1,468.02 / $1,468.02	Facility	52	$1,468.02	$1,468.02	$1,468.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.50 / $183.50 / $183.50	Facility	AS	$183.50	$183.50	$183.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,621.32 / $2,107.71 / $3,795.71	Professional		$1,621.32	$2,107.71	$3,795.71
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,554.85 / $4,554.85 / $5,814.13	Professional	22	$4,554.85	$4,554.85	$5,814.13
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,328.50 / $1,328.50 / $1,695.79	Professional	52	$1,328.50	$1,328.50	$1,695.79
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $121.46 / $121.46 / $155.04	Professional	80	$121.46	$121.46	$155.04
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.73 / $60.73 / $77.52	Professional	AS	$60.73	$60.73	$77.52
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