Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.24 / $131.24 / $131.24	Facility		$131.24	$131.24	$131.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $74.36 / $102.11	Professional		$74.34	$74.36	$102.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.24 / $131.24 / $131.24	Facility		$131.24	$131.24	$131.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $74.36 / $87.49	Professional		$74.36	$74.36	$87.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $90.77 / $90.77 / $90.77	Professional		$90.77	$90.77	$90.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $89.23 / $111.54	Professional		$74.36	$89.23	$111.54
United Facility/Professional Professional Modifier Low / Median / High Price $74.36 / $77.23 / $111.54	Professional		$74.36	$77.23	$111.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $73.37 / $94.05	Professional		$66.86	$73.37	$94.05