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 $65.56 / $108.50 / $186.77	Professional		$65.56	$108.50	$186.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.68 / $123.68 / $123.68	Facility		$123.68	$123.68	$123.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.75 / $205.66 / $302.45	Professional		$88.75	$205.66	$302.45
HMSA Facility/Professional Professional Modifier Low / Median / High Price $113.45 / $134.16 / $288.27	Professional		$113.45	$134.16	$288.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $207.68 / $252.04	Professional		$77.48	$207.68	$252.04
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 $169.29 / $252.04 / $311.06	Professional		$169.29	$252.04	$311.06
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $194.74 / $335.60	Professional		$36.65	$194.74	$335.60