Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,797.95 / $4,592.00 / $6,915.00	Facility		$1,797.95	$4,592.00	$6,915.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,361.69 / $8,967.21 / $21,657.35	Facility		$2,361.69	$8,967.21	$21,657.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $2,722.07 / $2,722.07 / $2,722.07	Facility		$2,722.07	$2,722.07	$2,722.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $2,011.86 / $4,635.00	Facility		$500.00	$2,011.86	$4,635.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $199.12 / $199.12 / $199.12	Facility	AS	$199.12	$199.12	$199.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $2,035.33 / $2,991.05 / $5,118.34	Professional		$2,035.33	$2,991.05	$5,118.34
Kaiser Permanente Facility/Professional Professional Modifier 22 Low / Median / High Price $6,142.01 / $6,142.01 / $6,142.01	Professional	22	$6,142.01	$6,142.01	$6,142.01
Kaiser Permanente Facility/Professional Professional Modifier 80 Low / Median / High Price $163.79 / $163.79 / $163.79	Professional	80	$163.79	$163.79	$163.79
Kaiser Permanente Facility/Professional Professional Modifier AS Low / Median / High Price $81.89 / $81.89 / $81.89	Professional	AS	$81.89	$81.89	$81.89
United Facility/Professional Facility Modifier Low / Median / High Price $1,998.00 / $9,172.00 / $18,613.00	Facility		$1,998.00	$9,172.00	$18,613.00