Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $279.33 / $279.33	Facility		$279.33	$279.33	$279.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $174.75 / $237.62	Professional		$173.03	$174.75	$237.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $279.33 / $279.33 / $279.33	Facility		$279.33	$279.33	$279.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.75 / $173.03 / $198.86	Professional		$165.75	$173.03	$198.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $206.31 / $206.31 / $206.31	Professional		$206.31	$206.31	$206.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $207.64 / $259.55	Professional		$173.03	$207.64	$259.55
United Facility/Professional Professional Modifier Low / Median / High Price $169.03 / $182.99 / $259.55	Professional		$169.03	$182.99	$259.55
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $164.92 / $200.51	Professional		$133.66	$164.92	$200.51