Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $392.79 / $3,391.00 / $6,915.00	Facility		$392.79	$3,391.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,875.00 / $7,875.00 / $7,875.00	Facility		$7,875.00	$7,875.00	$7,875.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $246.61 / $348.22 / $448.86	Facility		$246.61	$348.22	$448.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $293.27 / $2,225.00 / $57,200.00	Facility		$293.27	$2,225.00	$57,200.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $179.89 / $179.89 / $179.89	Facility	62	$179.89	$179.89	$179.89
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $28.78 / $28.78 / $28.78	Facility	AS	$28.78	$28.78	$28.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.32 / $385.20 / $1,335.00	Professional		$295.32	$385.20	$1,335.00
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $891.17 / $891.17 / $891.17	Professional	22	$891.17	$891.17	$891.17
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $278.49 / $278.49 / $278.49	Professional	62	$278.49	$278.49	$278.49
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $23.76 / $23.76 / $23.76	Professional	80	$23.76	$23.76	$23.76
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $11.88 / $11.88 / $11.88	Professional	AS	$11.88	$11.88	$11.88
United Facility/Professional Facility Modifier Low / Median / High Price $175.00 / $1,550.00 / $2,665.00	Facility		$175.00	$1,550.00	$2,665.00