Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.91 / $199.91 / $199.91	Facility		$199.91	$199.91	$199.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.59 / $112.73 / $173.33	Professional		$15.59	$112.73	$173.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $199.91 / $199.91 / $209.33	Professional		$199.91	$199.91	$209.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $18.02 / $18.02 / $171.10	Professional		$18.02	$18.02	$171.10
United Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $140.38 / $199.91	Professional		$74.59	$140.38	$199.91
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $171.79 / $171.79 / $249.90	Professional		$171.79	$171.79	$249.90