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 $54.29 / $172.53 / $419.11	Professional		$54.29	$172.53	$419.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.22 / $140.96 / $663.13	Professional	50	$88.22	$140.96	$663.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.09 / $315.36 / $378.44	Professional		$221.09	$315.36	$378.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $91.97 / $108.76 / $336.54	Professional		$91.97	$108.76	$336.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $267.43 / $315.36	Professional		$63.29	$267.43	$315.36
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 $174.67 / $289.95 / $315.36	Professional		$174.67	$289.95	$315.36
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $53.76 / $80.95 / $245.49	Professional		$53.76	$80.95	$245.49