Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $2,747.00 / $2,898.00	Facility		$988.00	$2,747.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.44 / $97.44 / $120.01	Professional		$97.44	$97.44	$120.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.88 / $164.56 / $197.48	Professional		$125.88	$164.56	$197.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $140.15 / $161.43 / $180.04	Professional		$140.15	$161.43	$180.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.88 / $139.55 / $164.56	Professional		$101.88	$139.55	$164.56
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 $130.88 / $162.65 / $188.19	Professional		$130.88	$162.65	$188.19
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $118.66 / $241.21	Professional		$29.27	$118.66	$241.21