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 $141.83 / $197.30 / $627.52	Professional		$141.83	$197.30	$627.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.83 / $228.80 / $274.56	Professional		$178.83	$228.80	$274.56
HMSA Facility/Professional Professional Modifier Low / Median / High Price $206.54 / $244.23 / $284.19	Professional		$206.54	$244.23	$284.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $140.43 / $194.02 / $228.80	Professional		$140.43	$194.02	$228.80
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 $177.02 / $228.80 / $284.30	Professional		$177.02	$228.80	$284.30
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $165.45 / $247.21	Professional		$117.04	$165.45	$247.21