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 $210.90 / $268.57 / $278.52	Professional		$210.90	$268.57	$278.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.11 / $300.00 / $892.98	Professional		$246.11	$300.00	$892.98
HMSA Facility/Professional Professional Modifier Low / Median / High Price $333.99 / $375.25 / $451.87	Professional		$333.99	$375.25	$451.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $247.63 / $270.14 / $315.17	Professional		$247.63	$270.14	$315.17
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 $229.62 / $294.39 / $468.18	Professional		$229.62	$294.39	$468.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $38.53 / $204.69 / $305.83	Professional		$38.53	$204.69	$305.83