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 $116.04 / $123.50 / $156.65	Professional		$116.04	$123.50	$156.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.86 / $165.53 / $326.64	Professional		$132.86	$165.53	$326.64
HMSA Facility/Professional Professional Modifier Low / Median / High Price $193.83 / $217.78 / $250.45	Professional		$193.83	$217.78	$250.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.65 / $145.80 / $170.10	Professional		$133.65	$145.80	$170.10
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $1,078.00 / $1,078.00	Facility		$1,078.00	$1,078.00	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $123.93 / $151.88 / $212.01	Professional		$123.93	$151.88	$212.01
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $112.55 / $169.48	Professional		$21.19	$112.55	$169.48