Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $855.77 / $4,592.00 / $6,915.00	Facility		$855.77	$4,592.00	$6,915.00
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 $1,269.11 / $1,493.09 / $2,052.50	Facility		$1,269.11	$1,493.09	$2,052.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.00 / $1,658.10 / $4,005.76	Facility		$512.00	$1,658.10	$4,005.76
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $80.59 / $80.59 / $80.59	Facility	AS	$80.59	$80.59	$80.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $716.31 / $931.20 / $1,676.97	Professional		$716.31	$931.20	$1,676.97
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,012.36 / $2,012.36 / $2,568.73	Professional	22	$2,012.36	$2,012.36	$2,568.73
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $53.66 / $53.66 / $68.50	Professional	80	$53.66	$53.66	$68.50
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $26.83 / $26.83 / $34.25	Professional	AS	$26.83	$26.83	$34.25
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