Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,105.96 / $6,915.00 / $14,497.00	Facility		$2,105.96	$6,915.00	$14,497.00
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 $2,000.41 / $2,000.41 / $2,000.41	Facility		$2,000.41	$2,000.41	$2,000.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,512.50	Facility		$200.00	$617.00	$1,512.50
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $148.22 / $148.22 / $148.22	Facility	AS	$148.22	$148.22	$148.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,310.68 / $1,703.88 / $3,910.13	Professional		$1,310.68	$1,703.88	$3,910.13
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,682.14 / $3,682.14 / $4,700.14	Professional	22	$3,682.14	$3,682.14	$4,700.14
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $98.19 / $98.19 / $125.34	Professional	80	$98.19	$98.19	$125.34
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $49.10 / $49.10 / $62.67	Professional	AS	$49.10	$49.10	$62.67
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