Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $349.75 / $4,592.00 / $6,915.00	Facility		$349.75	$4,592.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $3,801.18 / $10,304.31	Facility		$659.95	$3,801.18	$10,304.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $552.77 / $552.77 / $552.77	Facility		$552.77	$552.77	$552.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $589.00 / $835.00	Facility		$200.00	$589.00	$835.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $243.96 / $243.96 / $243.96	Facility	62	$243.96	$243.96	$243.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $39.03 / $39.03 / $39.03	Facility	AS	$39.03	$39.03	$39.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $345.16 / $448.71 / $989.23	Professional		$345.16	$448.71	$989.23
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $303.02 / $303.02 / $386.80	Professional	62	$303.02	$303.02	$386.80
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $25.86 / $25.86 / $33.01	Professional	80	$25.86	$25.86	$33.01
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $12.93 / $12.93 / $16.50	Professional	AS	$12.93	$12.93	$16.50
United Facility/Professional Facility Modifier Low / Median / High Price $741.00 / $5,664.00 / $11,889.00	Facility		$741.00	$5,664.00	$11,889.00