Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.36 / $251.36 / $251.36	Facility		$251.36	$251.36	$251.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $126.76	Professional		$89.34	$89.34	$126.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.36 / $251.36 / $251.36	Facility		$251.36	$251.36	$251.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $89.34 / $159.97	Professional		$89.34	$89.34	$159.97
HMSA Facility/Professional Professional Modifier Low / Median / High Price $165.98 / $165.98 / $165.98	Professional		$165.98	$165.98	$165.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $107.21 / $134.02	Professional		$89.34	$107.21	$134.02
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $94.70 / $159.97	Professional		$89.34	$94.70	$159.97
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $126.63 / $158.29 / $171.98	Professional		$126.63	$158.29	$171.98