Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $864.50 / $2,747.00 / $2,898.00	Facility		$864.50	$2,747.00	$2,898.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $237.80 / $631.41	Professional		$90.67	$237.80	$631.41
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $147.60 / $240.50 / $1,402.63	Professional	50	$147.60	$240.50	$1,402.63
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.97 / $21.97 / $57.11	Professional	53	$21.97	$21.97	$57.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $255.63 / $323.89 / $388.67	Professional		$255.63	$323.89	$388.67
HMSA Facility/Professional Professional Modifier Low / Median / High Price $175.70 / $207.77 / $395.98	Professional		$175.70	$207.77	$395.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.72 / $274.66 / $323.89	Professional		$122.72	$274.66	$323.89
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 $264.29 / $323.89 / $397.73	Professional		$264.29	$323.89	$397.73
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $152.16 / $1,350.00 / $3,663.00	Professional		$152.16	$1,350.00	$3,663.00