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 $120.64 / $148.33 / $187.73	Professional		$120.64	$148.33	$187.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $812.63 / $812.63 / $812.63	Facility		$812.63	$812.63	$812.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.63 / $211.72 / $393.80	Professional		$138.63	$211.72	$393.80
HMSA Facility/Professional Professional Modifier Low / Median / High Price $207.47 / $244.02 / $271.24	Professional		$207.47	$244.02	$271.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.15 / $198.25 / $252.32	Professional		$156.15	$198.25	$252.32
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 $159.12 / $225.29 / $293.49	Professional		$159.12	$225.29	$293.49
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $30.84 / $167.43 / $246.72	Professional		$30.84	$167.43	$246.72