Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,906.90 / $5,063.00 / $9,488.00	Facility		$1,906.90	$5,063.00	$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 $1,167.05 / $1,541.51 / $2,126.21	Facility		$1,167.05	$1,541.51	$2,126.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,260.01 / $3,555.00 / $57,200.00	Facility		$1,260.01	$3,555.00	$57,200.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $783.15 / $783.15 / $783.15	Facility	62	$783.15	$783.15	$783.15
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $125.30 / $125.30 / $125.30	Facility	AS	$125.30	$125.30	$125.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,280.83 / $1,882.27 / $5,856.06	Professional		$1,280.83	$1,882.27	$5,856.06
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $3,865.18 / $3,865.18 / $3,865.18	Professional	22	$3,865.18	$3,865.18	$3,865.18
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $1,207.86 / $1,207.86 / $1,207.86	Professional	62	$1,207.86	$1,207.86	$1,207.86
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $103.07 / $103.07 / $103.07	Professional	80	$103.07	$103.07	$103.07
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $51.54 / $51.54 / $51.54	Professional	AS	$51.54	$51.54	$51.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,725.00 / $9,576.00 / $18,613.00	Facility		$2,725.00	$9,576.00	$18,613.00