Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $525.60 / $525.60 / $2,898.00	Facility		$525.60	$525.60	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.94 / $97.82 / $195.00	Professional		$55.94	$97.82	$195.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.62 / $115.95 / $207.18	Professional		$62.62	$115.95	$207.18
HMSA Facility/Professional Professional Modifier Low / Median / High Price $119.35 / $140.38 / $167.83	Professional		$119.35	$140.38	$167.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.43 / $92.76 / $129.86	Professional		$46.43	$92.76	$129.86
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 $83.48 / $115.95 / $153.66	Professional		$83.48	$115.95	$153.66
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $97.85 / $3,956.00	Professional		$29.27	$97.85	$3,956.00