Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.19 / $117.19 / $117.19	Professional		$117.19	$117.19	$117.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.80 / $162.80 / $162.80	Facility		$162.80	$162.80	$162.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $140.54 / $225.43 / $225.43	Professional		$140.54	$225.43	$225.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $204.94 / $214.60 / $214.60	Professional		$204.94	$214.60	$214.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.96 / $204.94 / $286.92	Professional		$122.96	$204.94	$286.92
United Facility/Professional Professional Modifier Low / Median / High Price $142.81 / $162.80 / $225.43	Professional		$142.81	$162.80	$225.43
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $99.97 / $165.09 / $195.07	Professional		$99.97	$165.09	$195.07