Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $263.80 / $263.80 / $263.80	Facility		$263.80	$263.80	$263.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $180.68	Professional		$164.25	$164.25	$180.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.81 / $263.81 / $263.81	Facility		$263.81	$263.81	$263.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.63 / $164.25 / $183.01	Professional		$156.63	$164.25	$183.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $189.87 / $189.87 / $189.87	Professional		$189.87	$189.87	$189.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $197.10 / $246.38	Professional		$164.25	$197.10	$246.38
United Facility/Professional Professional Modifier Low / Median / High Price $156.04 / $164.25 / $246.38	Professional		$156.04	$164.25	$246.38
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $129.29 / $169.53 / $196.74	Professional		$129.29	$169.53	$196.74