Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $651.00 / $2,747.00 / $3,883.00	Facility		$651.00	$2,747.00	$3,883.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.09 / $316.42 / $626.73	Professional		$166.09	$316.42	$626.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.78 / $359.33 / $480.38	Professional		$196.78	$359.33	$480.38
HMSA Facility/Professional Professional Modifier Low / Median / High Price $260.10 / $313.16 / $574.15	Professional		$260.10	$313.16	$574.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.30 / $422.73 / $538.02	Professional		$180.30	$422.73	$538.02
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 $433.65 / $457.02 / $601.55	Professional		$433.65	$457.02	$601.55
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.38 / $311.61 / $4,597.00	Professional		$147.38	$311.61	$4,597.00