Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $859.94 / $4,592.00 / $6,915.00	Facility		$859.94	$4,592.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,801.18 / $10,304.31	Facility		$659.95	$3,801.18	$10,304.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,241.53 / $1,241.53 / $1,241.53	Facility		$1,241.53	$1,241.53	$1,241.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $981.24	Facility		$200.00	$617.00	$981.24
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $96.41 / $96.41 / $96.41	Facility	AS	$96.41	$96.41	$96.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $852.04 / $1,107.65 / $1,994.72	Professional		$852.04	$1,107.65	$1,994.72
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,393.66 / $2,393.66 / $3,055.45	Professional	22	$2,393.66	$2,393.66	$3,055.45
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $63.83 / $63.83 / $81.48	Professional	80	$63.83	$63.83	$81.48
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $31.92 / $31.92 / $40.74	Professional	AS	$31.92	$31.92	$40.74
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