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 $69.64 / $135.93 / $137.08	Professional		$69.64	$135.93	$137.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $646.98 / $646.98 / $646.98	Professional	50	$646.98	$646.98	$646.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.11 / $105.53 / $126.63	Professional		$86.11	$105.53	$126.63
HMSA Facility/Professional Professional Modifier Low / Median / High Price $120.60 / $142.61 / $161.31	Professional		$120.60	$142.61	$161.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $49.12 / $89.49 / $105.53	Professional		$49.12	$89.49	$105.53
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $1,078.00 / $1,078.00	Facility		$1,078.00	$1,078.00	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $86.11 / $105.53 / $116.42	Professional		$86.11	$105.53	$116.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $77.59 / $129.81	Professional		$29.27	$77.59	$129.81