Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $792.18 / $792.18 / $792.18	Facility		$792.18	$792.18	$792.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $465.18	Professional		$422.89	$422.89	$465.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $792.17 / $792.17 / $792.17	Facility		$792.17	$792.17	$792.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $422.89 / $479.85	Professional		$422.89	$422.89	$479.85
HMSA Facility/Professional Professional Modifier Low / Median / High Price $583.80 / $583.80 / $583.80	Professional		$583.80	$583.80	$583.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $422.89 / $507.47 / $634.34	Professional		$422.89	$507.47	$634.34
United Facility/Professional Professional Modifier Low / Median / High Price $407.87 / $446.83 / $634.34	Professional		$407.87	$446.83	$634.34
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $296.30 / $483.84 / $528.29	Professional		$296.30	$483.84	$528.29