Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,219.94 / $6,726.00 / $14,497.00	Facility		$2,219.94	$6,726.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $3,640.00 / $9,156.52	Facility		$814.00	$3,640.00	$9,156.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,959.47 / $2,959.47 / $2,959.47	Facility		$2,959.47	$2,959.47	$2,959.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $625.00 / $2,230.33	Facility		$200.00	$625.00	$2,230.33
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $218.55 / $218.55 / $218.55	Facility	AS	$218.55	$218.55	$218.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,925.40 / $2,503.02 / $4,507.58	Professional		$1,925.40	$2,503.02	$4,507.58
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,409.10 / $5,409.10 / $6,904.55	Professional	22	$5,409.10	$5,409.10	$6,904.55
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $144.24 / $144.24 / $184.12	Professional	80	$144.24	$144.24	$184.12
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $72.12 / $72.12 / $92.06	Professional	AS	$72.12	$72.12	$92.06
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