Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $973.49 / $5,055.00 / $7,268.00	Facility		$973.49	$5,055.00	$7,268.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,911.00 / $3,911.00 / $10,902.00	Facility	50	$3,911.00	$3,911.00	$10,902.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,146.00 / $3,081.88 / $6,065.87	Facility		$1,146.00	$3,081.88	$6,065.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,037.66 / $1,220.78 / $1,683.02	Facility		$1,037.66	$1,220.78	$1,683.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.00 / $1,658.10 / $2,580.60	Facility		$512.00	$1,658.10	$2,580.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $66.25 / $66.25 / $66.25	Facility	AS	$66.25	$66.25	$66.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $587.36 / $763.57 / $1,375.09	Professional		$587.36	$763.57	$1,375.09
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,650.11 / $1,650.11 / $2,106.30	Professional	22	$1,650.11	$1,650.11	$2,106.30
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $44.00 / $44.00 / $56.17	Professional	80	$44.00	$44.00	$56.17
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $22.00 / $22.00 / $28.08	Professional	AS	$22.00	$22.00	$28.08
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