Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,975.23 / $5,063.00 / $9,312.90	Facility		$1,975.23	$5,063.00	$9,312.90
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 $1,917.34 / $1,917.34 / $1,917.34	Facility		$1,917.34	$1,917.34	$1,917.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,470.67 / $3,451.00 / $57,200.00	Facility		$1,470.67	$3,451.00	$57,200.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $913.41 / $913.41 / $913.41	Facility	62	$913.41	$913.41	$913.41
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $146.15 / $146.15 / $146.15	Facility	AS	$146.15	$146.15	$146.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,494.02 / $2,195.56 / $3,757.10	Professional		$1,494.02	$2,195.56	$3,757.10
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $4,508.52 / $4,508.52 / $4,508.52	Professional	22	$4,508.52	$4,508.52	$4,508.52
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,408.91 / $1,408.91 / $1,408.91	Professional	62	$1,408.91	$1,408.91	$1,408.91
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	80	$120.23	$120.23	$120.23
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $60.11 / $60.11 / $60.11	Professional	AS	$60.11	$60.11	$60.11
United Facility/Professional Facility Modifier Low / Median / High Price $2,725.00 / $9,576.00 / $18,878.00	Facility		$2,725.00	$9,576.00	$18,878.00