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 $102.79 / $181.96 / $286.41	Professional		$102.79	$181.96	$286.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.25 / $219.68 / $263.61	Professional		$179.25	$219.68	$263.61
HMSA Facility/Professional Professional Modifier Low / Median / High Price $165.75 / $201.04 / $270.51	Professional		$165.75	$201.04	$270.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.55 / $193.31 / $219.68	Professional		$127.55	$193.31	$219.68
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 $177.86 / $219.68 / $413.42	Professional		$177.86	$219.68	$413.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $131.50 / $219.98	Professional		$29.58	$131.50	$219.98