Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $411.52 / $411.52 / $411.52	Facility		$411.52	$411.52	$411.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $258.63 / $258.64 / $355.19	Professional		$258.63	$258.64	$355.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $411.51 / $411.51 / $411.51	Facility		$411.51	$411.51	$411.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.77 / $258.64 / $298.72	Professional		$246.77	$258.64	$298.72
HMSA Facility/Professional Professional Modifier Low / Median / High Price $309.92 / $309.92 / $309.92	Professional		$309.92	$309.92	$309.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.64 / $310.37 / $387.96	Professional		$258.64	$310.37	$387.96
United Facility/Professional Professional Modifier Low / Median / High Price $253.91 / $258.64 / $387.96	Professional		$253.91	$258.64	$387.96
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $181.20 / $248.93 / $301.20	Professional		$181.20	$248.93	$301.20