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 $123.90 / $177.90 / $213.53	Professional		$123.90	$177.90	$213.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.36 / $219.91 / $256.93	Professional		$157.36	$219.91	$256.93
HMSA Facility/Professional Professional Modifier Low / Median / High Price $211.07 / $257.97 / $318.49	Professional		$211.07	$257.97	$318.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.41 / $226.09 / $287.76	Professional		$148.41	$226.09	$287.76
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 $209.65 / $256.93 / $311.27	Professional		$209.65	$256.93	$311.27
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.33 / $1,350.00 / $3,663.00	Professional		$158.33	$1,350.00	$3,663.00