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 $129.52 / $311.73 / $751.53	Professional		$129.52	$311.73	$751.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.68 / $265.56 / $577.35	Professional		$160.68	$265.56	$577.35
HMSA Facility/Professional Professional Modifier Low / Median / High Price $195.07 / $232.07 / $345.97	Professional		$195.07	$232.07	$345.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.94 / $216.70 / $297.43	Professional		$133.94	$216.70	$297.43
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 $186.09 / $265.56 / $332.09	Professional		$186.09	$265.56	$332.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $37.83 / $168.64 / $300.25	Professional		$37.83	$168.64	$300.25