Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,618.48 / $5,803.00 / $14,497.00	Facility		$2,618.48	$5,803.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $5,120.04 / $17,035.45	Facility		$875.00	$5,120.04	$17,035.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,469.52 / $2,469.52 / $2,469.52	Facility		$2,469.52	$2,469.52	$2,469.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,879.13	Facility		$200.00	$617.00	$1,879.13
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $184.06 / $184.06 / $184.06	Facility	AS	$184.06	$184.06	$184.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,627.12 / $2,115.26 / $4,681.99	Professional		$1,627.12	$2,115.26	$4,681.99
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,571.14 / $4,571.14 / $5,834.92	Professional	22	$4,571.14	$4,571.14	$5,834.92
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $121.90 / $121.90 / $155.60	Professional	80	$121.90	$121.90	$155.60
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.95 / $60.95 / $77.80	Professional	AS	$60.95	$60.95	$77.80
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