Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.22 / $157.78 / $202.50	Facility		$139.22	$157.78	$202.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.46 / $58.46 / $58.46	Professional		$58.46	$58.46	$58.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $202.50 / $202.50 / $202.50	Professional		$202.50	$202.50	$202.50
HMSA Facility/Professional Professional Modifier Low / Median / High Price $90.84 / $113.55 / $176.70	Professional		$90.84	$113.55	$176.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $185.63 / $202.50 / $236.25	Professional		$185.63	$202.50	$236.25
United Facility/Professional Professional Modifier Low / Median / High Price $168.75 / $202.50 / $253.13	Professional		$168.75	$202.50	$253.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $110.66 / $199.13 / $303.75	Professional		$110.66	$199.13	$303.75