Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.65 / $172.65 / $172.65	Professional		$172.65	$172.65	$172.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $368.27 / $368.27 / $368.27	Facility		$368.27	$368.27	$368.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $366.26 / $366.26 / $509.95	Professional		$366.26	$366.26	$509.95
HMSA Facility/Professional Professional Modifier Low / Median / High Price $463.59 / $485.43 / $485.43	Professional		$463.59	$485.43	$485.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.14 / $463.59 / $649.03	Professional		$278.14	$463.59	$649.03
United Facility/Professional Professional Modifier Low / Median / High Price $255.70 / $368.27 / $509.95	Professional		$255.70	$368.27	$509.95
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $202.75 / $373.43 / $441.25	Professional		$202.75	$373.43	$441.25