Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,989.00 / $5,917.00 / $9,488.00	Facility		$1,989.00	$5,917.00	$9,488.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,206.31 / $5,656.86 / $12,326.53	Facility		$2,206.31	$5,656.86	$12,326.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,226.89 / $2,226.89 / $2,226.89	Facility		$2,226.89	$2,226.89	$2,226.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $1,694.77 / $57,200.00	Facility		$500.00	$1,694.77	$57,200.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $168.25 / $168.25 / $168.25	Facility	AS	$168.25	$168.25	$168.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,726.08 / $2,401.50 / $5,148.68	Professional		$1,726.08	$2,401.50	$5,148.68
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $138.90 / $138.90 / $138.90	Professional	80	$138.90	$138.90	$138.90
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $69.45 / $69.45 / $69.45	Professional	AS	$69.45	$69.45	$69.45
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,193.00 / $18,613.00	Facility		$1,998.00	$9,193.00	$18,613.00