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 $96.70 / $121.90 / $160.90	Professional		$96.70	$121.90	$160.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.36 / $164.67 / $193.20	Professional		$123.36	$164.67	$193.20
HMSA Facility/Professional Professional Modifier Low / Median / High Price $159.06 / $196.95 / $243.16	Professional		$159.06	$196.95	$243.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.78 / $170.02 / $216.38	Professional		$112.78	$170.02	$216.38
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 $157.65 / $193.20 / $239.84	Professional		$157.65	$193.20	$239.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $120.94 / $512.00 / $3,956.00	Professional		$120.94	$512.00	$3,956.00