Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $9,775.81 / $14,823.00	Facility		$2,800.00	$9,775.81	$14,823.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,406.00 / $13,676.00 / $15,786.00	Facility	50	$9,406.00	$13,676.00	$15,786.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,012.00 / $3,616.62 / $9,026.11	Facility		$1,012.00	$3,616.62	$9,026.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $996.62 / $1,172.49 / $1,402.08	Facility		$996.62	$1,172.49	$1,402.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $643.98 / $3,237.36 / $9,829.00	Facility		$643.98	$3,237.36	$9,829.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $63.83 / $63.83 / $63.83	Facility	AS	$63.83	$63.83	$63.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $565.78 / $735.51 / $1,473.82	Professional		$565.78	$735.51	$1,473.82
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,589.46 / $1,589.46 / $2,028.90	Professional	22	$1,589.46	$1,589.46	$2,028.90
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $42.39 / $42.39 / $54.10	Professional	80	$42.39	$42.39	$54.10
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $21.19 / $21.19 / $27.05	Professional	AS	$21.19	$21.19	$27.05
United Facility/Professional Facility Modifier Low / Median / High Price $851.00 / $6,868.00 / $16,000.00	Facility		$851.00	$6,868.00	$16,000.00