Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $144.71 / $164.00 / $210.48	Facility		$144.71	$164.00	$210.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.96 / $92.96 / $92.96	Professional		$92.96	$92.96	$92.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.60 / $210.48 / $210.48	Professional		$95.60	$210.48	$210.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $180.60 / $213.11 / $248.33	Professional		$180.60	$213.11	$248.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $192.94 / $210.48 / $245.56	Professional		$192.94	$210.48	$245.56
United Facility/Professional Professional Modifier Low / Median / High Price $175.40 / $210.48 / $263.10	Professional		$175.40	$210.48	$263.10
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $149.09 / $236.79 / $394.65	Professional		$149.09	$236.79	$394.65