Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $223.87	Professional		$131.83	$177.83	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $501.19	Facility		$194.98	$194.98	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $562.34 / $794.33	Professional		$194.98	$562.34	$794.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $676.08	Professional		$645.65	$645.65	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $645.65 / $741.31	Professional		$389.05	$645.65	$741.31
United Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $190.55 / $194.98	Facility		$151.36	$190.55	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $436.52 / $691.83	Professional		$177.83	$436.52	$691.83