Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,100.36 / $5,063.00 / $9,488.00	Facility		$2,100.36	$5,063.00	$9,488.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,627.10 / $3,627.10 / $11,650.50	Facility	50	$3,627.10	$3,627.10	$11,650.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,751.89 / $5,625.04 / $12,227.65	Facility		$1,751.89	$5,625.04	$12,227.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,287.25 / $2,733.33 / $3,718.14	Facility		$2,287.25	$2,733.33	$3,718.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,476.67 / $2,225.00 / $57,200.00	Facility		$1,476.67	$2,225.00	$57,200.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $146.47 / $146.47 / $146.47	Facility	AS	$146.47	$146.47	$146.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,492.25 / $2,192.96 / $6,533.48	Professional		$1,492.25	$2,192.96	$6,533.48
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,503.17 / $4,503.17 / $4,503.17	Professional	22	$4,503.17	$4,503.17	$4,503.17
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $120.08 / $120.08 / $120.08	Professional	80	$120.08	$120.08	$120.08
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.04 / $60.04 / $60.04	Professional	AS	$60.04	$60.04	$60.04
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