Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,406.17 / $6,017.00 / $13,676.00	Facility		$2,406.17	$6,017.00	$13,676.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,204.21 / $5,204.21 / $5,204.21	Facility	50	$5,204.21	$5,204.21	$5,204.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,249.96 / $7,021.16 / $14,848.89	Facility		$2,249.96	$7,021.16	$14,848.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,093.92 / $2,296.41 / $3,526.64	Facility		$2,093.92	$2,296.41	$3,526.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,774.00 / $4,774.00 / $6,037.66	Facility		$4,774.00	$4,774.00	$6,037.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,096.89 / $1,425.96 / $3,960.38	Professional		$1,096.89	$1,425.96	$3,960.38
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,700.88 / $2,700.88 / $2,700.88	Professional	22	$2,700.88	$2,700.88	$2,700.88
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $72.02 / $72.02 / $72.02	Professional	80	$72.02	$72.02	$72.02
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $36.01 / $36.01 / $36.01	Professional	AS	$36.01	$36.01	$36.01
United Facility/Professional Facility Modifier Low / Median / High Price $1,738.00 / $8,264.00 / $15,490.00	Facility		$1,738.00	$8,264.00	$15,490.00