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 $97.87 / $149.97 / $200.97	Professional		$97.87	$149.97	$200.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.13 / $205.91 / $246.81	Professional		$122.13	$205.91	$246.81
HMSA Facility/Professional Professional Modifier Low / Median / High Price $177.86 / $210.32 / $306.08	Professional		$177.86	$210.32	$306.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.66 / $217.20 / $276.43	Professional		$127.66	$217.20	$276.43
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 $201.40 / $246.81 / $306.89	Professional		$201.40	$246.81	$306.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.58 / $152.72 / $268.67	Professional		$33.58	$152.72	$268.67