Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $2,818.38 / $4,466.84	Facility		$870.96	$2,818.38	$4,466.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,778.28 / $2,630.27 / $4,466.84	Facility	50	$1,778.28	$2,630.27	$4,466.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $363.08	Professional		$138.04	$169.82	$363.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $512.86 / $1,659.59 / $1,778.28	Professional	50	$512.86	$1,659.59	$1,778.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $204.17	Professional		$162.18	$190.55	$204.17
HMSA Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $5,495.41	Professional		$218.78	$288.40	$5,495.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $181.97 / $223.87	Professional		$165.96	$181.97	$223.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $1,698.24 / $1,698.24	Facility		$1,698.24	$1,698.24	$1,698.24
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $257.04	Professional		$169.82	$199.53	$257.04
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $3,235.94 / $6,165.95	Professional		$218.78	$3,235.94	$6,165.95