Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.56 / $82.56 / $82.56	Facility		$82.56	$82.56	$82.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.85 / $129.85 / $172.92	Professional		$113.85	$129.85	$172.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.56 / $82.56 / $82.56	Facility		$82.56	$82.56	$82.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.91 / $116.61 / $140.24	Professional		$86.91	$116.61	$140.24
HMSA Facility/Professional Professional Modifier Low / Median / High Price $111.92 / $121.32 / $144.83	Professional		$111.92	$121.32	$144.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.77 / $124.17 / $134.96	Professional		$118.77	$124.17	$134.96
United Facility/Professional Professional Modifier Low / Median / High Price $100.92 / $134.96 / $177.92	Professional		$100.92	$134.96	$177.92
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.42 / $118.83 / $190.58	Professional		$70.42	$118.83	$190.58