Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.10 / $872.10 / $3,107.60	Facility		$872.10	$872.10	$3,107.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.20 / $107.71 / $472.68	Professional		$53.20	$107.71	$472.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.95 / $113.58 / $208.40	Professional		$81.95	$113.58	$208.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $106.64 / $118.49 / $141.96	Professional		$106.64	$118.49	$141.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.37 / $96.41 / $104.44	Professional		$88.37	$96.41	$104.44
United Facility/Professional Professional Modifier Low / Median / High Price $100.43 / $107.28 / $158.87	Professional		$100.43	$107.28	$158.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $69.88 / $115.21 / $195.97	Professional		$69.88	$115.21	$195.97