Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.82 / $124.82 / $124.82	Facility		$124.82	$124.82	$124.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.90 / $78.97 / $5,400.00	Professional		$75.90	$78.97	$5,400.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.82 / $124.82 / $124.82	Facility		$124.82	$124.82	$124.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.91 / $75.91 / $75.91	Professional		$75.91	$75.91	$75.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $103.50 / $103.50 / $103.50	Professional		$103.50	$103.50	$103.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $91.09 / $106.27	Professional		$83.50	$91.09	$106.27
United Facility/Professional Professional Modifier Low / Median / High Price $75.91 / $85.06 / $113.87	Professional		$75.91	$85.06	$113.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $45.01 / $71.16 / $85.78	Professional		$45.01	$71.16	$85.78