Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,400.54 / $4,708.00 / $6,915.00	Facility		$1,400.54	$4,708.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,862.88 / $11,108.64	Facility		$659.95	$3,862.88	$11,108.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,958.60 / $1,958.60 / $1,958.60	Facility		$1,958.60	$1,958.60	$1,958.60
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 $156.62 / $156.62 / $156.62	Facility	AS	$156.62	$156.62	$156.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,386.78 / $1,758.33 / $3,216.41	Professional		$1,386.78	$1,758.33	$3,216.41
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,895.93 / $3,895.93 / $4,973.04	Professional	22	$3,895.93	$3,895.93	$4,973.04
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $103.89 / $103.89 / $132.61	Professional	80	$103.89	$103.89	$132.61
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $51.95 / $51.95 / $66.31	Professional	AS	$51.95	$51.95	$66.31
United Facility/Professional Facility Modifier Low / Median / High Price $576.00 / $3,895.00 / $6,995.00	Facility		$576.00	$3,895.00	$6,995.00