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 $123.14 / $193.77 / $252.03	Professional		$123.14	$193.77	$252.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $244.10 / $520.83	Professional		$141.44	$244.10	$520.83
HMSA Facility/Professional Professional Modifier Low / Median / High Price $207.59 / $246.96 / $365.92	Professional		$207.59	$246.96	$365.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $246.42 / $338.23	Professional		$147.60	$246.42	$338.23
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 $206.08 / $299.88 / $380.62	Professional		$206.08	$299.88	$380.62
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $39.70 / $180.90 / $315.13	Professional		$39.70	$180.90	$315.13