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 $59.15 / $118.84 / $289.12	Professional		$59.15	$118.84	$289.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.34 / $219.78 / $263.73	Professional		$179.34	$219.78	$263.73
HMSA Facility/Professional Professional Modifier Low / Median / High Price $130.09 / $153.83 / $253.02	Professional		$130.09	$153.83	$253.02
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.50 / $193.40 / $219.78	Professional		$114.50	$193.40	$219.78
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 $144.86 / $219.78 / $418.02	Professional		$144.86	$219.78	$418.02
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $110.08 / $209.30	Professional		$30.17	$110.08	$209.30