Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,486.00 / $3,883.00 / $4,705.00	Facility		$1,486.00	$3,883.00	$4,705.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.97 / $169.28 / $285.05	Professional		$149.97	$169.28	$285.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.80 / $226.73 / $226.73	Professional		$165.80	$226.73	$226.73
HMSA Facility/Professional Professional Modifier Low / Median / High Price $242.38 / $272.32 / $321.33	Professional		$242.38	$272.32	$321.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $199.52 / $217.66 / $253.93	Professional		$199.52	$217.66	$253.93
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 $185.01 / $226.73 / $283.55	Professional		$185.01	$226.73	$283.55
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $165.63 / $277.64	Professional		$29.27	$165.63	$277.64