Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $176.36 / $176.36 / $176.36	Facility		$176.36	$176.36	$176.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $111.19	Professional		$100.09	$100.09	$111.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $176.35 / $176.35 / $176.35	Facility		$176.35	$176.35	$176.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $100.09 / $116.34	Professional		$100.09	$100.09	$116.34
HMSA Facility/Professional Professional Modifier Low / Median / High Price $120.70 / $120.70 / $120.70	Professional		$120.70	$120.70	$120.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.09 / $120.10 / $150.13	Professional		$100.09	$120.10	$150.13
United Facility/Professional Professional Modifier Low / Median / High Price $98.89 / $104.70 / $150.13	Professional		$98.89	$104.70	$150.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $111.68 / $125.07	Professional		$89.34	$111.68	$125.07