Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.98 / $96.31 / $123.60	Facility		$84.98	$96.31	$123.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.03 / $123.60 / $123.60	Professional		$73.03	$123.60	$123.60
HMSA Facility/Professional Professional Modifier Low / Median / High Price $167.42 / $220.82 / $258.44	Professional		$167.42	$220.82	$258.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $123.60 / $154.50	Professional		$103.00	$123.60	$154.50
United Facility/Professional Professional Modifier Low / Median / High Price $43.26 / $123.60 / $199.97	Professional		$43.26	$123.60	$199.97
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $115.36 / $187.01 / $258.93	Professional		$115.36	$187.01	$258.93