Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
HMSA Facility/Professional Facility Modifier Low / Median / High Price $2,805.00 / $10,901.00 / $20,477.00	Facility		$2,805.00	$10,901.00	$20,477.00
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $280.00	Facility		$110.00	$110.00	$280.00
University Health Alliance Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $110.00 / $110.00	Facility		$110.00	$110.00	$110.00