Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,094.00 / $7,092.00 / $13,283.40	Facility		$3,094.00	$7,092.00	$13,283.40
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 $703.31 / $946.78 / $1,048.22	Facility		$703.31	$946.78	$1,048.22
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 $703.31 / $914.30 / $1,851.84	Professional		$703.31	$914.30	$1,851.84
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $2,126.94 / $2,126.94 / $2,126.94	Professional	22	$2,126.94	$2,126.94	$2,126.94
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $56.72 / $56.72 / $56.72	Professional	80	$56.72	$56.72	$56.72
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $28.36 / $28.36 / $28.36	Professional	AS	$28.36	$28.36	$28.36
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