Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Facility		$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $51.29 / $58.88	Professional		$39.81	$51.29	$58.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $173.78	Facility		$67.61	$67.61	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $131.83 / $186.21	Professional		$67.61	$131.83	$186.21
HMSA Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $190.55	Professional		$181.97	$181.97	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $173.78	Professional		$89.13	$151.36	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $61.66	Facility		$48.98	$48.98	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $138.04 / $173.78	Professional		$35.48	$138.04	$173.78