Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $168.80 / $168.80 / $168.80	Facility		$168.80	$168.80	$168.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.78 / $103.03	Professional		$75.03	$75.78	$103.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.80 / $168.80 / $168.80	Facility		$168.80	$168.80	$168.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $75.02 / $97.96	Professional		$75.02	$75.02	$97.96
HMSA Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $95.93 / $95.93	Professional		$95.93	$95.93	$95.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $90.03 / $112.54	Professional		$75.03	$90.03	$112.54
United Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $79.34 / $112.55	Professional		$75.03	$79.34	$112.55
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $93.23 / $127.03	Professional		$57.92	$93.23	$127.03