Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,483.33 / $4,841.00 / $6,915.00	Facility		$1,483.33	$4,841.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $725.00 / $3,585.69 / $10,304.31	Facility		$725.00	$3,585.69	$10,304.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,696.56 / $1,696.56 / $1,696.56	Facility		$1,696.56	$1,696.56	$1,696.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,233.00	Facility		$200.00	$617.00	$1,233.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $131.97 / $131.97 / $131.97	Facility	AS	$131.97	$131.97	$131.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,168.40 / $1,518.92 / $2,735.38	Professional		$1,168.40	$1,518.92	$2,735.38
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,282.46 / $3,282.46 / $4,189.93	Professional	22	$3,282.46	$3,282.46	$4,189.93
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $87.53 / $87.53 / $111.73	Professional	80	$87.53	$87.53	$111.73
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $43.77 / $43.77 / $55.87	Professional	AS	$43.77	$43.77	$55.87
United Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $4,666.00 / $8,554.00	Facility		$651.00	$4,666.00	$8,554.00