Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,620.73 / $6,915.00 / $14,497.00	Facility		$1,620.73	$6,915.00	$14,497.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $762.48 / $1,204.38 / $1,728.48	Facility	52	$762.48	$1,204.38	$1,728.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $5,136.49 / $17,035.45	Facility		$875.00	$5,136.49	$17,035.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,287.36 / $2,287.36 / $2,287.36	Facility		$2,287.36	$2,287.36	$2,287.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,742.51	Facility		$200.00	$617.00	$1,742.51
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,366.02 / $1,366.02 / $1,366.02	Facility	52	$1,366.02	$1,366.02	$1,366.02
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $170.75 / $170.75 / $170.75	Facility	AS	$170.75	$170.75	$170.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,509.98 / $1,962.97 / $4,287.76	Professional		$1,509.98	$1,962.97	$4,287.76
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,242.04 / $4,242.04 / $5,414.84	Professional	22	$4,242.04	$4,242.04	$5,414.84
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $1,237.26 / $1,237.26 / $1,579.33	Professional	52	$1,237.26	$1,237.26	$1,579.33
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $113.12 / $113.12 / $144.40	Professional	80	$113.12	$113.12	$144.40
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $56.56 / $56.56 / $72.20	Professional	AS	$56.56	$56.56	$72.20
United Facility/Professional Facility Modifier Low / Median / High Price $741.00 / $5,664.00 / $11,889.00	Facility		$741.00	$5,664.00	$11,889.00