Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,592.00 / $9,408.39 / $18,258.00	Facility		$4,592.00	$9,408.39	$18,258.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $11,870.00 / $11,870.00 / $13,214.00	Facility	22	$11,870.00	$11,870.00	$13,214.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,931.00 / $6,019.63 / $13,137.87	Facility		$1,931.00	$6,019.63	$13,137.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $1,201.60 / $1,330.35	Facility		$895.00	$1,201.60	$1,330.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,184.57 / $14,959.00 / $24,659.00	Facility		$6,184.57	$14,959.00	$24,659.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $895.00 / $1,163.50 / $5,767.55	Professional		$895.00	$1,163.50	$5,767.55
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,706.62 / $2,706.62 / $2,706.62	Professional	22	$2,706.62	$2,706.62	$2,706.62
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $72.18 / $72.18 / $72.18	Professional	80	$72.18	$72.18	$72.18
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $36.09 / $36.09 / $36.09	Professional	AS	$36.09	$36.09	$36.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $7,271.50 / $21,407.17 / $23,903.54	Facility		$7,271.50	$21,407.17	$23,903.54
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