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 $159.28 / $342.18 / $1,693.00	Professional		$159.28	$342.18	$1,693.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $503.76 / $628.79 / $754.55	Professional		$503.76	$628.79	$754.55
HMSA Facility/Professional Professional Modifier Low / Median / High Price $301.74 / $351.54 / $630.88	Professional		$301.74	$351.54	$630.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $211.55 / $533.21 / $628.79	Professional		$211.55	$533.21	$628.79
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 $445.73 / $624.88 / $744.44	Professional		$445.73	$624.88	$744.44
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $255.47 / $1,402.00 / $3,725.00	Professional		$255.47	$1,402.00	$3,725.00