Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,300.00 / $6,915.00 / $14,497.00	Facility		$2,300.00	$6,915.00	$14,497.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,226.13 / $6,105.48 / $13,137.87	Facility		$2,226.13	$6,105.48	$13,137.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,306.82 / $2,533.04 / $3,890.03	Facility		$2,306.82	$2,533.04	$3,890.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,186.00 / $7,258.00 / $10,047.00	Facility		$4,186.00	$7,258.00	$10,047.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,208.41 / $1,570.93 / $3,062.13	Professional		$1,208.41	$1,570.93	$3,062.13
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,975.47 / $2,975.47 / $2,975.47	Professional	22	$2,975.47	$2,975.47	$2,975.47
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $79.34 / $79.34 / $79.34	Professional	80	$79.34	$79.34	$79.34
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $39.67 / $39.67 / $39.67	Professional	AS	$39.67	$39.67	$39.67
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00