Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $204.17	Professional		$100.00	$131.83	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $331.13	Facility		$169.82	$169.82	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $371.54 / $524.81	Professional		$169.82	$371.54	$524.81
HMSA Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $446.68	Professional		$426.58	$426.58	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $426.58 / $489.78	Professional		$257.04	$426.58	$489.78
United Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $151.36 / $177.83	Facility		$147.91	$151.36	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $288.40 / $457.09	Professional		$131.83	$288.40	$457.09