Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $988.00 / $2,747.00 / $2,898.00	Facility		$988.00	$2,747.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $117.96 / $179.09	Professional		$79.93	$117.96	$179.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.02 / $170.36 / $204.44	Professional		$139.02	$170.36	$204.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $129.08 / $150.38 / $230.74	Professional		$129.08	$150.38	$230.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.11 / $144.47 / $170.36	Professional		$84.11	$144.47	$170.36
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 $139.02 / $170.36 / $248.81	Professional		$139.02	$170.36	$248.81
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $131.52 / $3,113.00	Professional		$71.34	$131.52	$3,113.00