Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,113.80 / $8,788.50 / $14,497.00	Facility		$4,113.80	$8,788.50	$14,497.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,901.97 / $9,924.40 / $20,259.84	Facility	50	$4,901.97	$9,924.40	$20,259.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,603.22 / $4,429.60 / $9,365.64	Facility		$1,603.22	$4,429.60	$9,365.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $742.98 / $897.77 / $1,443.86	Facility		$742.98	$897.77	$1,443.86
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 $642.90 / $835.77 / $2,620.85	Professional		$642.90	$835.77	$2,620.85
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $1,944.24 / $1,944.24 / $1,944.24	Professional	22	$1,944.24	$1,944.24	$1,944.24
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $51.85 / $51.85 / $51.85	Professional	80	$51.85	$51.85	$51.85
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $25.92 / $25.92 / $25.92	Professional	AS	$25.92	$25.92	$25.92
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