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 $97.23 / $164.96 / $251.90	Professional		$97.23	$164.96	$251.90
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 $109.90 / $233.78 / $464.53	Professional		$109.90	$233.78	$464.53
HMSA Facility/Professional Professional Modifier Low / Median / High Price $159.35 / $189.57 / $376.96	Professional		$159.35	$189.57	$376.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.30 / $233.78 / $320.88	Professional		$112.30	$233.78	$320.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $1,981.00 / $1,981.00	Facility		$1,981.00	$1,981.00	$1,981.00
United Facility/Professional Professional Modifier Low / Median / High Price $187.74 / $285.14 / $371.41	Professional		$187.74	$285.14	$371.41
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $137.77 / $1,402.00 / $3,725.00	Professional		$137.77	$1,402.00	$3,725.00