Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,327.78 / $5,045.00 / $6,915.00	Facility		$2,327.78	$5,045.00	$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 $3,411.86 / $3,411.86 / $3,411.86	Facility		$3,411.86	$3,411.86	$3,411.86
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 62 Low / Median / High Price $1,628.99 / $1,628.99 / $1,628.99	Facility	62	$1,628.99	$1,628.99	$1,628.99
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $260.64 / $260.64 / $260.64	Facility	AS	$260.64	$260.64	$260.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,308.16 / $3,000.61 / $5,447.52	Professional		$2,308.16	$3,000.61	$5,447.52
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $8,277.16 / $8,925.60 / $8,925.60	Professional	22	$8,277.16	$8,925.60	$8,925.60
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $2,586.61 / $2,789.25 / $2,789.25	Professional	62	$2,586.61	$2,789.25	$2,789.25
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $220.72 / $238.02 / $238.02	Professional	80	$220.72	$238.02	$238.02
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $110.36 / $119.01 / $119.01	Professional	AS	$110.36	$119.01	$119.01
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