Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,065.23 / $5,595.00 / $9,008.00	Facility		$2,065.23	$5,595.00	$9,008.00
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 $2,309.35 / $2,309.35 / $2,309.35	Facility		$2,309.35	$2,309.35	$2,309.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,700.59 / $1,700.59 / $4,830.16	Facility		$1,700.59	$1,700.59	$4,830.16
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $168.44 / $168.44 / $168.44	Facility	AS	$168.44	$168.44	$168.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,718.18 / $2,524.98 / $4,327.83	Professional		$1,718.18	$2,524.98	$4,327.83
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $5,184.95 / $5,184.95 / $5,184.95	Professional	22	$5,184.95	$5,184.95	$5,184.95
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $138.27 / $138.27 / $138.27	Professional	80	$138.27	$138.27	$138.27
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $69.13 / $69.13 / $69.13	Professional	AS	$69.13	$69.13	$69.13
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