Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.33 / $43.33 / $43.33	Professional		$43.33	$43.33	$43.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.53 / $160.53 / $160.53	Facility		$160.53	$160.53	$160.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.21 / $222.29 / $222.29	Professional		$104.21	$222.29	$222.29
HMSA Facility/Professional Professional Modifier Low / Median / High Price $202.08 / $211.60 / $211.60	Professional		$202.08	$211.60	$211.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $121.25 / $202.08 / $282.91	Professional		$121.25	$202.08	$282.91
United Facility/Professional Professional Modifier Low / Median / High Price $97.18 / $160.53 / $222.29	Professional		$97.18	$160.53	$222.29
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $88.38 / $162.78 / $192.34	Professional		$88.38	$162.78	$192.34