Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.72 / $213.72 / $213.72	Facility		$213.72	$213.72	$213.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $213.71 / $213.71 / $213.71	Facility		$213.71	$213.71	$213.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $95.26	Professional		$69.73	$69.73	$95.26
HMSA Facility/Professional Professional Modifier Low / Median / High Price $115.91 / $115.91 / $115.91	Professional		$115.91	$115.91	$115.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $83.67 / $97.62	Professional		$69.73	$83.67	$97.62
United Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $95.26 / $104.60	Professional		$69.73	$95.26	$104.60
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $65.28 / $96.06 / $145.44	Professional		$65.28	$96.06	$145.44