Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $385.00 / $988.00 / $2,898.00	Facility		$385.00	$988.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $115.76 / $138.75	Professional		$72.50	$115.76	$138.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.75 / $170.04 / $204.05	Professional		$138.75	$170.04	$204.05
HMSA Facility/Professional Professional Modifier Low / Median / High Price $170.75 / $201.92 / $249.43	Professional		$170.75	$201.92	$249.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.56 / $149.63 / $176.84	Professional		$81.56	$149.63	$176.84
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 $138.75 / $170.04 / $328.56	Professional		$138.75	$170.04	$328.56
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $88.11 / $170.96	Professional		$29.27	$88.11	$170.96