Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,199.54 / $5,063.00 / $6,915.00	Facility		$1,199.54	$5,063.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $383.07 / $597.02 / $728.45	Facility	52	$383.07	$597.02	$728.45
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 $1,127.18 / $1,127.18 / $1,127.18	Facility		$1,127.18	$1,127.18	$1,127.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $875.09	Facility		$200.00	$617.00	$875.09
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $688.97 / $688.97 / $688.97	Facility	52	$688.97	$688.97	$688.97
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $86.12 / $86.12 / $86.12	Facility	AS	$86.12	$86.12	$86.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $763.80 / $992.94 / $1,788.13	Professional		$763.80	$992.94	$1,788.13
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,145.76 / $2,145.76 / $2,739.00	Professional	22	$2,145.76	$2,145.76	$2,739.00
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $625.85 / $625.85 / $798.88	Professional	52	$625.85	$625.85	$798.88
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $57.22 / $57.22 / $73.04	Professional	80	$57.22	$57.22	$73.04
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.61 / $28.61 / $36.52	Professional	AS	$28.61	$28.61	$36.52
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