Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,791.00 / $5,809.00 / $12,390.00	Facility		$1,791.00	$5,809.00	$12,390.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,595.87 / $8,313.99	Facility		$659.95	$3,595.87	$8,313.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,695.49 / $1,695.49 / $1,695.49	Facility		$1,695.49	$1,695.49	$1,695.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,283.26	Facility		$200.00	$617.00	$1,283.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $125.90 / $125.90 / $125.90	Facility	AS	$125.90	$125.90	$125.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,108.51 / $1,441.06 / $3,587.40	Professional		$1,108.51	$1,441.06	$3,587.40
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,975.14 / $4,304.88 / $4,304.88	Professional	22	$3,975.14	$4,304.88	$4,304.88
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $106.00 / $114.80 / $114.80	Professional	80	$106.00	$114.80	$114.80
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $53.00 / $57.40 / $57.40	Professional	AS	$53.00	$57.40	$57.40
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