Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.09 / $209.18 / $233.63	Facility		$33.09	$209.18	$233.63
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $162.05 / $162.05 / $162.05	Facility	25	$162.05	$162.05	$162.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $75.95 / $159.00	Professional		$42.47	$75.95	$159.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $46.55 / $77.56 / $217.79	Professional	25	$46.55	$77.56	$217.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.00 / $148.00 / $148.00	Facility		$148.00	$148.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $83.01 / $128.38	Professional		$48.70	$83.01	$128.38
HMSA Facility/Professional Professional Modifier Low / Median / High Price $81.80 / $91.69 / $111.90	Professional		$81.80	$91.69	$111.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.84 / $78.94 / $104.26	Professional		$50.84	$78.94	$104.26
United Facility/Professional Professional Modifier Low / Median / High Price $63.61 / $93.09 / $123.15	Professional		$63.61	$93.09	$123.15
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $87.04 / $172.50	Professional		$50.00	$87.04	$172.50