Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.10 / $120.10 / $120.10	Facility		$120.10	$120.10	$120.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $66.00 / $90.63	Professional		$66.00	$66.00	$90.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.09 / $120.09 / $120.09	Facility		$120.09	$120.09	$120.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $66.00 / $77.06	Professional		$65.50	$66.00	$77.06
HMSA Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $79.95 / $79.95	Professional		$79.95	$79.95	$79.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $79.20 / $99.00	Professional		$66.00	$79.20	$99.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $69.37 / $99.00	Professional		$65.50	$69.37	$99.00
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $75.04 / $82.84	Professional		$51.50	$75.04	$82.84