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 $85.35 / $103.68 / $103.68	Professional		$85.35	$103.68	$103.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.52 / $129.83 / $136.04	Professional		$81.52	$129.83	$136.04
HMSA Facility/Professional Professional Modifier Low / Median / High Price $142.12 / $159.68 / $188.42	Professional		$142.12	$159.68	$188.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.25 / $124.63 / $145.40	Professional		$114.25	$124.63	$145.40
United Facility/Professional Facility Modifier Low / Median / High Price $1,106.00 / $1,106.00 / $1,106.00	Facility		$1,106.00	$1,106.00	$1,106.00
United Facility/Professional Professional Modifier Low / Median / High Price $105.94 / $129.83 / $165.62	Professional		$105.94	$129.83	$165.62
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $110.89 / $140.41	Professional		$17.55	$110.89	$140.41