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 $127.28 / $146.09 / $214.67	Professional		$127.28	$146.09	$214.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.28 / $173.98 / $208.77	Professional		$136.28	$173.98	$208.77
HMSA Facility/Professional Professional Modifier Low / Median / High Price $203.63 / $222.85 / $263.10	Professional		$203.63	$222.85	$263.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.10 / $167.02 / $194.85	Professional		$153.10	$167.02	$194.85
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 $141.96 / $173.98 / $230.64	Professional		$141.96	$173.98	$230.64
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $23.92 / $127.10 / $191.40	Professional		$23.92	$127.10	$191.40