Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $694.40 / $6,915.00 / $14,497.00	Facility		$694.40	$6,915.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,600.00 / $2,663.37 / $3,027.60	Facility		$1,600.00	$2,663.37	$3,027.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $572.36 / $572.36 / $572.36	Facility		$572.36	$572.36	$572.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $440.76 / $440.76 / $440.76	Facility		$440.76	$440.76	$440.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $43.36 / $43.36 / $43.36	Facility	AS	$43.36	$43.36	$43.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.29 / $498.28 / $1,145.43	Professional		$383.29	$498.28	$1,145.43
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,076.82 / $1,076.82 / $1,374.52	Professional	22	$1,076.82	$1,076.82	$1,374.52
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $28.72 / $28.72 / $36.65	Professional	80	$28.72	$28.72	$36.65
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $14.36 / $14.36 / $18.32	Professional	AS	$14.36	$14.36	$18.32
United Facility/Professional Facility Modifier Low / Median / High Price $765.00 / $5,332.00 / $11,889.00	Facility		$765.00	$5,332.00	$11,889.00