Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.75 / $58.75 / $61.13	Professional		$58.75	$58.75	$61.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.18 / $202.18 / $202.18	Facility		$202.18	$202.18	$202.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.18 / $72.18 / $279.95	Professional		$72.18	$72.18	$279.95
HMSA Facility/Professional Professional Modifier Low / Median / High Price $254.50 / $266.49 / $266.49	Professional		$254.50	$266.49	$266.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $152.69 / $254.50 / $356.30	Professional		$152.69	$254.50	$356.30
United Facility/Professional Professional Modifier Low / Median / High Price $74.69 / $202.18 / $279.95	Professional		$74.69	$202.18	$279.95
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $111.29 / $205.01 / $242.24	Professional		$111.29	$205.01	$242.24