Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,851.92 / $5,063.00 / $7,631.00	Facility		$1,851.92	$5,063.00	$7,631.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $925.96 / $1,406.74 / $1,772.49	Facility	52	$925.96	$1,406.74	$1,772.49
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 $2,640.73 / $2,640.73 / $2,640.73	Facility		$2,640.73	$2,640.73	$2,640.73
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 $1,648.76 / $1,648.76 / $1,648.76	Facility	52	$1,648.76	$1,648.76	$1,648.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $206.10 / $206.10 / $206.10	Facility	AS	$206.10	$206.10	$206.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,822.17 / $2,368.82 / $4,265.92	Professional		$1,822.17	$2,368.82	$4,265.92
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,119.10 / $5,119.10 / $6,534.40	Professional	22	$5,119.10	$5,119.10	$6,534.40
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,493.07 / $1,493.07 / $1,905.87	Professional	52	$1,493.07	$1,493.07	$1,905.87
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $136.51 / $136.51 / $174.25	Professional	80	$136.51	$136.51	$174.25
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $68.25 / $68.25 / $87.13	Professional	AS	$68.25	$68.25	$87.13
United Facility/Professional Facility Modifier Low / Median / High Price $485.00 / $2,907.00 / $8,133.00	Facility		$485.00	$2,907.00	$8,133.00