Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.14 / $164.14 / $164.14	Facility		$164.14	$164.14	$164.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $91.34 / $125.43	Professional		$91.34	$91.34	$125.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $164.13 / $164.13 / $164.13	Facility		$164.13	$164.13	$164.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $91.34 / $105.87	Professional		$91.02	$91.34	$105.87
HMSA Facility/Professional Professional Modifier Low / Median / High Price $109.83 / $109.83 / $109.83	Professional		$109.83	$109.83	$109.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $109.61 / $137.01	Professional		$91.34	$109.61	$137.01
United Facility/Professional Professional Modifier Low / Median / High Price $89.99 / $93.32 / $137.01	Professional		$89.99	$93.32	$137.01
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $86.24 / $93.43 / $106.75	Professional		$86.24	$93.43	$106.75