Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $864.50 / $2,747.00 / $2,898.00	Facility		$864.50	$2,747.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.35 / $116.71 / $245.18	Professional		$50.35	$116.71	$245.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $165.27 / $188.94	Professional		$82.26	$165.27	$188.94
HMSA Facility/Professional Professional Modifier Low / Median / High Price $105.93 / $130.94 / $397.79	Professional		$105.93	$130.94	$397.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $71.01 / $166.27 / $211.61	Professional		$71.01	$166.27	$211.61
United Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $1,689.00 / $1,689.00	Facility		$1,689.00	$1,689.00	$1,689.00
United Facility/Professional Professional Modifier Low / Median / High Price $154.16 / $188.94 / $254.88	Professional		$154.16	$188.94	$254.88
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $84.04 / $205.94	Professional		$29.27	$84.04	$205.94