Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Facility		$1,258.93	$1,258.93	$1,258.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,258.93 / $1,479.11	Professional		$1,174.90	$1,258.93	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,258.93 / $1,258.93	Professional		$1,258.93	$1,258.93	$1,258.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,949.84 / $1,949.84 / $2,290.87	Professional		$1,949.84	$1,949.84	$2,290.87
United Facility/Professional Facility Modifier Low / Median / High Price $12.88 / $512.86 / $630.96	Facility		$12.88	$512.86	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,288.25 / $1,288.25	Professional		$1,288.25	$1,288.25	$1,288.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,258.93	Professional		$1,202.26	$1,202.26	$1,258.93