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 $119.80 / $273.72 / $378.56	Professional		$119.80	$273.72	$378.56
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 $149.22 / $327.80 / $572.53	Professional		$149.22	$327.80	$572.53
HMSA Facility/Professional Professional Modifier Low / Median / High Price $194.16 / $229.60 / $511.05	Professional		$194.16	$229.60	$511.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $320.57 / $439.99	Professional		$129.84	$320.57	$439.99
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 $264.63 / $388.17 / $492.67	Professional		$264.63	$388.17	$492.67
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $163.02 / $1,402.00 / $3,663.00	Professional		$163.02	$1,402.00	$3,663.00