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 $101.00 / $136.58 / $188.90	Professional		$101.00	$136.58	$188.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.93 / $185.56 / $385.00	Professional		$121.93	$185.56	$385.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $172.86 / $201.39 / $249.10	Professional		$172.86	$201.39	$249.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.36 / $166.86 / $218.18	Professional		$122.36	$166.86	$218.18
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 $147.47 / $194.80 / $274.82	Professional		$147.47	$194.80	$274.82
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $146.35 / $217.88	Professional		$29.27	$146.35	$217.88