Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $196.78 / $196.78 / $196.78	Facility		$196.78	$196.78	$196.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.60 / $111.16 / $218.54	Professional		$96.60	$111.16	$218.54
HMSA Facility/Professional Professional Modifier Low / Median / High Price $198.67 / $208.03 / $208.03	Professional		$198.67	$208.03	$208.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.07 / $198.67 / $278.14	Professional		$139.07	$198.67	$278.14
United Facility/Professional Professional Modifier Low / Median / High Price $74.40 / $218.54 / $218.54	Professional		$74.40	$218.54	$218.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $137.34 / $166.77 / $198.67	Professional		$137.34	$166.77	$198.67