Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $2,884.03 / $2,884.03	Facility		$245.47	$2,884.03	$2,884.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $117.49	Professional		$38.02	$61.66	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $102.33	Professional		$83.18	$83.18	$102.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $120.23	Professional		$74.13	$85.11	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $102.33 / $120.23	Professional		$43.65	$102.33	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility		$1,071.52	$1,071.52	$1,071.52
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $128.82	Professional		$54.95	$83.18	$128.82
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $51.29 / $102.33	Professional		$14.79	$51.29	$102.33