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 $128.11 / $219.28 / $388.10	Professional		$128.11	$219.28	$388.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $155.59 / $257.91 / $292.70	Professional		$155.59	$257.91	$292.70
HMSA Facility/Professional Professional Modifier Low / Median / High Price $230.95 / $273.10 / $372.06	Professional		$230.95	$273.10	$372.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.99 / $257.58 / $327.82	Professional		$174.99	$257.58	$327.82
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 $238.84 / $292.70 / $370.16	Professional		$238.84	$292.70	$370.16
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $183.41 / $1,402.00 / $3,725.00	Professional		$183.41	$1,402.00	$3,725.00