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 $76.84 / $117.45 / $254.96	Professional		$76.84	$117.45	$254.96
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 $91.02 / $167.40 / $402.80	Professional		$91.02	$167.40	$402.80
HMSA Facility/Professional Professional Modifier Low / Median / High Price $133.38 / $158.69 / $227.55	Professional		$133.38	$158.69	$227.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.25 / $273.89 / $375.94	Professional		$94.25	$273.89	$375.94
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 $128.03 / $240.41 / $335.66	Professional		$128.03	$240.41	$335.66
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.75 / $116.22 / $379.04	Professional		$47.75	$116.22	$379.04