Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.74 / $287.74 / $287.74	Facility		$287.74	$287.74	$287.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.93 / $173.93 / $173.93	Professional		$173.93	$173.93	$173.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $287.74 / $287.74 / $287.74	Facility		$287.74	$287.74	$287.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $172.22 / $172.22	Professional		$172.22	$172.22	$172.22
HMSA Facility/Professional Professional Modifier Low / Median / High Price $237.15 / $237.15 / $237.15	Professional		$237.15	$237.15	$237.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.44 / $206.67 / $241.11	Professional		$189.44	$206.67	$241.11
United Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $194.92 / $258.33	Professional		$172.22	$194.92	$258.33
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $77.02 / $150.50 / $196.54	Professional		$77.02	$150.50	$196.54