Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,486.00 / $2,747.00 / $3,883.00	Facility		$1,486.00	$2,747.00	$3,883.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $115.39 / $183.63	Professional		$57.43	$115.39	$183.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.41 / $141.85 / $170.22	Professional		$114.41	$141.85	$170.22
HMSA Facility/Professional Professional Modifier Low / Median / High Price $92.25 / $109.09 / $175.07	Professional		$92.25	$109.09	$175.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.91 / $120.29 / $141.85	Professional		$54.91	$120.29	$141.85
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 $115.75 / $141.85 / $183.86	Professional		$115.75	$141.85	$183.86
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $20.04 / $64.81 / $159.11	Professional		$20.04	$64.81	$159.11