Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $805.20 / $805.20 / $805.20	Facility		$805.20	$805.20	$805.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $805.20 / $805.20 / $805.20	Facility		$805.20	$805.20	$805.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.33 / $25.33 / $25.33	Professional		$25.33	$25.33	$25.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $12.78 / $12.78 / $12.78	Professional		$12.78	$12.78	$12.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $27.86 / $30.40 / $35.46	Professional		$27.86	$30.40	$35.46
United Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $38.00 / $44.49	Professional		$28.20	$38.00	$44.49
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $44.87 / $377.33 / $502.40	Professional		$44.87	$377.33	$502.40