Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,157.88 / $3,492.00 / $6,891.85	Facility		$1,157.88	$3,492.00	$6,891.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.06 / $359.26 / $2,274.00	Professional		$184.06	$359.26	$2,274.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.72 / $89.90 / $212.70	Professional	53	$40.72	$89.90	$212.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,088.40 / $1,088.40 / $1,088.40	Facility		$1,088.40	$1,088.40	$1,088.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.05 / $395.11 / $711.43	Professional		$229.05	$395.11	$711.43
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $68.08 / $214.84 / $220.49	Professional	53	$68.08	$214.84	$220.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $341.40 / $406.14 / $565.91	Professional		$341.40	$406.14	$565.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.76 / $359.65 / $493.64	Professional		$197.76	$359.65	$493.64
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $98.88 / $179.83 / $246.82	Professional	53	$98.88	$179.83	$246.82
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 $316.55 / $440.75 / $608.16	Professional		$316.55	$440.75	$608.16
United Facility/Professional Professional Modifier 53 Low / Median / High Price $179.92 / $220.49 / $220.49	Professional	53	$179.92	$220.49	$220.49
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $250.51 / $2,000.00 / $5,309.00	Professional		$250.51	$2,000.00	$5,309.00
University Health Alliance Facility/Professional Professional Modifier 53 Low / Median / High Price $103.19 / $968.00 / $3,831.00	Professional	53	$103.19	$968.00	$3,831.00