Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.90 / $204.90 / $204.90	Facility		$204.90	$204.90	$204.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.91 / $204.91 / $204.91	Facility		$204.91	$204.91	$204.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.69 / $294.69 / $294.69	Professional		$294.69	$294.69	$294.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $267.22 / $267.22 / $267.22	Professional		$267.22	$267.22	$267.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $324.16 / $353.63 / $412.57	Professional		$324.16	$353.63	$412.57
United Facility/Professional Professional Modifier Low / Median / High Price $219.64 / $294.69 / $442.04	Professional		$219.64	$294.69	$442.04
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $116.71 / $284.33	Professional		$34.96	$116.71	$284.33