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 $237.46 / $250.93 / $314.16	Professional		$237.46	$250.93	$314.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.27 / $318.50 / $579.48	Professional		$265.27	$318.50	$579.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $367.76 / $413.19 / $497.56	Professional		$367.76	$413.19	$497.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.77 / $304.13 / $354.82	Professional		$278.77	$304.13	$354.82
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 $245.56 / $316.80 / $467.72	Professional		$245.56	$316.80	$467.72
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $43.61 / $310.70 / $348.85	Professional		$43.61	$310.70	$348.85