Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.98 / $164.67 / $285.70	Professional		$107.98	$164.67	$285.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.41 / $219.56 / $263.48	Professional		$164.41	$219.56	$263.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $162.27 / $189.05 / $254.39	Professional		$162.27	$189.05	$254.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.72 / $186.19 / $219.56	Professional		$114.72	$186.19	$219.56
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $1,078.00 / $1,078.00	Facility		$1,078.00	$1,078.00	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.54 / $217.16 / $261.05	Professional		$159.54	$217.16	$261.05
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $137.38 / $222.52	Professional		$29.27	$137.38	$222.52