Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $184.42 / $184.42 / $184.42	Facility		$184.42	$184.42	$184.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $86.84	Professional		$68.20	$68.20	$86.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $184.43 / $184.43 / $184.43	Facility		$184.43	$184.43	$184.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $201.96	Professional		$68.20	$68.20	$201.96
HMSA Facility/Professional Professional Modifier Low / Median / High Price $209.53 / $209.53 / $209.53	Professional		$209.53	$209.53	$209.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $81.84 / $102.30	Professional		$68.20	$81.84	$102.30
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $72.29 / $201.96	Professional		$68.20	$72.29	$201.96
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $105.86 / $217.11	Professional		$59.42	$105.86	$217.11