Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,888.01 / $6,900.00 / $14,497.00	Facility		$1,888.01	$6,900.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $3,733.69 / $9,156.52	Facility		$814.00	$3,733.69	$9,156.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,582.63 / $2,582.63 / $2,582.63	Facility		$2,582.63	$2,582.63	$2,582.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $625.00 / $1,973.23	Facility		$200.00	$625.00	$1,973.23
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $193.42 / $193.42 / $193.42	Facility	AS	$193.42	$193.42	$193.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,706.66 / $2,218.66 / $3,995.50	Professional		$1,706.66	$2,218.66	$3,995.50
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,794.60 / $4,794.60 / $6,120.16	Professional	22	$4,794.60	$4,794.60	$6,120.16
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $127.86 / $127.86 / $163.19	Professional	80	$127.86	$127.86	$163.19
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $63.93 / $63.93 / $81.59	Professional	AS	$63.93	$63.93	$81.59
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