Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,303.03 / $5,045.00 / $6,915.00	Facility		$1,303.03	$5,045.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,538.99 / $5,842.74 / $15,411.81	Facility		$1,538.99	$5,842.74	$15,411.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,384.15 / $2,617.38 / $4,019.55	Facility		$2,384.15	$2,617.38	$4,019.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $550.00 / $550.00	Facility		$550.00	$550.00	$550.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,248.92 / $1,623.60 / $4,229.54	Professional		$1,248.92	$1,623.60	$4,229.54
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,075.22 / $3,075.22 / $3,075.22	Professional	22	$3,075.22	$3,075.22	$3,075.22
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $961.01 / $961.01 / $961.01	Professional	62	$961.01	$961.01	$961.01
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $82.01 / $82.01 / $82.01	Professional	80	$82.01	$82.01	$82.01
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $41.00 / $41.00 / $41.00	Professional	AS	$41.00	$41.00	$41.00
United Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $3,629.00 / $10,000.00	Facility		$607.00	$3,629.00	$10,000.00