Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $2,898.00 / $3,444.00	Facility		$988.00	$2,898.00	$3,444.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.38 / $163.25 / $255.28	Professional		$53.38	$163.25	$255.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.52 / $204.06 / $244.88	Professional		$166.52	$204.06	$244.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $91.58 / $106.70 / $2,278.00	Professional		$91.58	$106.70	$2,278.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $65.45 / $179.58 / $204.06	Professional		$65.45	$179.58	$204.06
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $1,106.00 / $1,106.00	Facility		$1,106.00	$1,106.00	$1,106.00
United Facility/Professional Professional Modifier Low / Median / High Price $166.52 / $204.06 / $373.48	Professional		$166.52	$204.06	$373.48
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $28.65 / $59.23 / $198.78	Professional		$28.65	$59.23	$198.78