Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,040.07 / $5,045.00 / $6,915.00	Facility		$1,040.07	$5,045.00	$6,915.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $520.04 / $633.95 / $989.72	Facility	52	$520.04	$633.95	$989.72
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 $1,419.36 / $1,419.36 / $1,419.36	Facility		$1,419.36	$1,419.36	$1,419.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $617.00 / $1,187.10	Facility		$200.00	$617.00	$1,187.10
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $931.75 / $931.75 / $931.75	Facility	52	$931.75	$931.75	$931.75
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $116.47 / $116.47 / $116.47	Facility	AS	$116.47	$116.47	$116.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,032.79 / $1,342.63 / $2,363.17	Professional		$1,032.79	$1,342.63	$2,363.17
Kaiser Permanente Facility/Professional Professional Modifier 52 Low / Median / High Price $846.25 / $846.25 / $1,080.22	Professional	52	$846.25	$846.25	$1,080.22
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $77.37 / $77.37 / $98.76	Professional	80	$77.37	$77.37	$98.76
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $38.69 / $38.69 / $49.38	Professional	AS	$38.69	$38.69	$49.38
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