Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $170.57 / $170.57 / $170.57	Facility		$170.57	$170.57	$170.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.90 / $133.46 / $217.46	Professional		$115.90	$133.46	$217.46
HMSA Facility/Professional Professional Modifier Low / Median / High Price $197.69 / $207.01 / $258.08	Professional		$197.69	$207.01	$258.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $177.92 / $276.77	Professional		$138.38	$177.92	$276.77
United Facility/Professional Professional Modifier Low / Median / High Price $83.34 / $170.57 / $217.46	Professional		$83.34	$170.57	$217.46
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $163.49 / $187.33	Professional		$162.87	$163.49	$187.33