Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,747.00 / $3,883.00 / $6,039.25	Facility		$2,747.00	$3,883.00	$6,039.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.10 / $359.23 / $1,088.00	Professional		$180.10	$359.23	$1,088.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.11 / $71.84 / $167.29	Professional	53	$37.11	$71.84	$167.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,088.40 / $1,088.40 / $1,088.40	Facility		$1,088.40	$1,088.40	$1,088.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.50 / $301.75 / $430.37	Professional		$207.50	$301.75	$430.37
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.90 / $88.55 / $264.58	Professional	53	$41.90	$88.55	$264.58
HMSA Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $392.41 / $566.26	Professional		$141.44	$392.41	$566.26
HMSA Facility/Professional Professional Modifier 53 Low / Median / High Price $151.25 / $170.80 / $282.14	Professional	53	$151.25	$170.80	$282.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.96 / $359.84 / $493.89	Professional		$197.96	$359.84	$493.89
Kaiser Permanente Facility/Professional Professional Modifier 53 Low / Median / High Price $98.98 / $179.92 / $246.95	Professional	53	$98.98	$179.92	$246.95
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 $220.49 / $344.39 / $812.47	Professional		$220.49	$344.39	$812.47
United Facility/Professional Professional Modifier 53 Low / Median / High Price $174.12 / $204.84 / $204.84	Professional	53	$174.12	$204.84	$204.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $495.31 / $2,099.00 / $5,309.00	Professional		$495.31	$2,099.00	$5,309.00
University Health Alliance Facility/Professional Professional Modifier 53 Low / Median / High Price $135.52 / $166.23 / $247.81	Professional	53	$135.52	$166.23	$247.81