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 $86.98 / $188.03 / $307.79	Professional		$86.98	$188.03	$307.79
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 $110.82 / $251.21 / $471.22	Professional		$110.82	$251.21	$471.22
HMSA Facility/Professional Professional Modifier Low / Median / High Price $177.10 / $213.84 / $374.68	Professional		$177.10	$213.84	$374.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.19 / $284.26 / $390.17	Professional		$95.19	$284.26	$390.17
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 $215.30 / $338.85 / $444.79	Professional		$215.30	$338.85	$444.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $116.48 / $1,402.00 / $3,663.00	Professional		$116.48	$1,402.00	$3,663.00