Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $135.47 / $135.47 / $135.47	Facility		$135.47	$135.47	$135.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $106.80 / $184.81	Professional		$96.42	$106.80	$184.81
HMSA Facility/Professional Professional Modifier Low / Median / High Price $168.01 / $175.93 / $219.78	Professional		$168.01	$175.93	$219.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $12.20 / $151.21 / $235.21	Professional		$12.20	$151.21	$235.21
United Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $110.95 / $184.81	Professional		$67.95	$110.95	$184.81
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $137.30 / $139.11 / $146.52	Professional		$137.30	$139.11	$146.52