Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
HMSA Facility/Professional Facility Modifier Low / Median / High Price $2,685.00 / $2,685.00 / $2,685.00	Facility		$2,685.00	$2,685.00	$2,685.00
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