Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,618.69 / $6,155.00 / $14,099.00	Facility		$1,618.69	$6,155.00	$14,099.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,732.27 / $6,472.76 / $14,965.63	Facility		$1,732.27	$6,472.76	$14,965.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,004.03 / $1,351.08 / $1,495.84	Facility		$1,004.03	$1,351.08	$1,495.84
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 $1,004.03 / $1,305.24 / $3,229.82	Professional		$1,004.03	$1,305.24	$3,229.82
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,036.34 / $3,036.34 / $3,036.34	Professional	22	$3,036.34	$3,036.34	$3,036.34
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $80.97 / $80.97 / $80.97	Professional	80	$80.97	$80.97	$80.97
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $40.47 / $40.47 / $40.47	Professional	AS	$40.47	$40.47	$40.47
United Facility/Professional Facility Modifier Low / Median / High Price $1,519.00 / $6,351.00 / $8,836.00	Facility		$1,519.00	$6,351.00	$8,836.00