Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.34 / $139.34 / $139.34	Facility		$139.34	$139.34	$139.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.34 / $32.20 / $123.90	Professional		$28.34	$32.20	$123.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $139.34 / $145.91 / $147.51	Professional		$139.34	$145.91	$147.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.56 / $101.38 / $157.69	Professional		$12.56	$101.38	$157.69
United Facility/Professional Professional Modifier Low / Median / High Price $20.73 / $33.76 / $139.34	Professional		$20.73	$33.76	$139.34
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $92.92 / $98.34 / $125.53	Professional		$92.92	$98.34	$125.53