Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,758.00 / $4,456.00 / $5,299.00	Facility		$1,758.00	$4,456.00	$5,299.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $187.03 / $697.82	Professional		$105.39	$187.03	$697.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $361.52 / $1,431.00 / $1,503.00	Professional	50	$361.52	$1,431.00	$1,503.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.99 / $221.92 / $252.20	Professional		$141.99	$221.92	$252.20
HMSA Facility/Professional Professional Modifier Low / Median / High Price $196.25 / $232.07 / $317.05	Professional		$196.25	$232.07	$317.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.53 / $221.94 / $282.45	Professional		$138.53	$221.94	$282.45
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 $205.80 / $252.20 / $313.39	Professional		$205.80	$252.20	$313.39
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $191.71 / $277.32	Professional		$34.67	$191.71	$277.32