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 $124.22 / $202.65 / $257.00	Professional		$124.22	$202.65	$257.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.90 / $233.84 / $287.19	Professional		$148.90	$233.84	$287.19
HMSA Facility/Professional Professional Modifier Low / Median / High Price $200.67 / $237.30 / $361.12	Professional		$200.67	$237.30	$361.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.12 / $252.73 / $321.64	Professional		$141.12	$252.73	$321.64
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 $234.35 / $287.19 / $357.71	Professional		$234.35	$287.19	$357.71
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $169.90 / $315.07	Professional		$39.69	$169.90	$315.07