Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,275.00 / $9,049.00 / $14,497.00	Facility		$4,275.00	$9,049.00	$14,497.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $358.74 / $664.86 / $4,353.12	Facility	52	$358.74	$664.86	$4,353.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,267.00 / $4,405.96 / $12,251.17	Facility		$1,267.00	$4,405.96	$12,251.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $716.72 / $964.56 / $1,146.75	Facility		$716.72	$964.56	$1,146.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $818.95 / $3,271.75 / $9,353.00	Facility		$818.95	$3,271.75	$9,353.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $645.72 / $645.72 / $645.72	Facility	52	$645.72	$645.72	$645.72
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.72 / $80.72 / $80.72	Facility	AS	$80.72	$80.72	$80.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $716.72 / $931.74 / $1,749.31	Professional		$716.72	$931.74	$1,749.31
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,013.52 / $2,013.52 / $2,570.17	Professional	22	$2,013.52	$2,013.52	$2,570.17
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $587.28 / $587.28 / $749.64	Professional	52	$587.28	$587.28	$749.64
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $53.69 / $53.69 / $68.54	Professional	80	$53.69	$53.69	$68.54
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $26.85 / $26.85 / $34.27	Professional	AS	$26.85	$26.85	$34.27
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,334.00 / $4,889.07 / $12,170.51	Facility		$4,334.00	$4,889.07	$12,170.51
United Facility/Professional Facility Modifier Low / Median / High Price $851.00 / $6,868.00 / $16,376.00	Facility		$851.00	$6,868.00	$16,376.00