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 $171.03 / $231.00 / $388.14	Professional		$171.03	$231.00	$388.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.43 / $261.82 / $300.49	Professional		$200.43	$261.82	$300.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $266.51 / $325.26 / $372.86	Professional		$266.51	$325.26	$372.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $188.39 / $264.43 / $336.55	Professional		$188.39	$264.43	$336.55
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 $245.20 / $300.49 / $370.43	Professional		$245.20	$300.49	$370.43
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $195.23 / $1,350.00 / $3,663.00	Professional		$195.23	$1,350.00	$3,663.00