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 $87.09 / $135.50 / $268.80	Professional		$87.09	$135.50	$268.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $167.64 / $205.44 / $246.53	Professional		$167.64	$205.44	$246.53
HMSA Facility/Professional Professional Modifier Low / Median / High Price $170.97 / $202.18 / $248.27	Professional		$170.97	$202.18	$248.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $180.79 / $205.44	Professional		$129.91	$180.79	$205.44
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $1,078.00 / $1,078.00	Facility		$1,078.00	$1,078.00	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $163.58 / $205.44 / $381.38	Professional		$163.58	$205.44	$381.38
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $96.88 / $1,500.00 / $4,035.20	Professional		$96.88	$1,500.00	$4,035.20