Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.85 / $988.00 / $2,898.00	Facility		$242.85	$988.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.80 / $226.97 / $387.61	Professional		$163.80	$226.97	$387.61
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $282.48 / $282.48 / $282.48	Professional	54	$282.48	$282.48	$282.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.75 / $297.49 / $356.99	Professional		$242.75	$297.49	$356.99
HMSA Facility/Professional Professional Modifier Low / Median / High Price $302.83 / $340.24 / $2,077.00	Professional		$302.83	$340.24	$2,077.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $246.26 / $279.83 / $313.42	Professional		$246.26	$279.83	$313.42
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 $222.53 / $295.22 / $364.40	Professional		$222.53	$295.22	$364.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.95 / $258.48 / $311.63	Professional		$38.95	$258.48	$311.63