Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $414.69 / $3,391.00 / $6,915.00	Facility		$414.69	$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 $337.52 / $337.52 / $337.52	Facility		$337.52	$337.52	$337.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $260.63 / $2,225.00 / $57,200.00	Facility		$260.63	$2,225.00	$57,200.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $159.84 / $159.84 / $159.84	Facility	62	$159.84	$159.84	$159.84
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $25.58 / $25.58 / $25.58	Facility	AS	$25.58	$25.58	$25.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $261.33 / $340.86 / $1,055.00	Professional		$261.33	$340.86	$1,055.00
Kaiser Permanente Facility/Professional Professional Modifier 62 Low / Median / High Price $246.44 / $246.44 / $246.44	Professional	62	$246.44	$246.44	$246.44
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $21.03 / $21.03 / $21.03	Professional	80	$21.03	$21.03	$21.03
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $10.51 / $10.51 / $10.51	Professional	AS	$10.51	$10.51	$10.51
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