Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $16.98 / $19.98	Facility	26	$14.99	$16.98	$19.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.83 / $64.83 / $64.83	Professional		$64.83	$64.83	$64.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.14 / $10.14 / $12.23	Professional	26	$10.14	$10.14	$12.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $92.15 / $151.69	Professional		$69.84	$92.15	$151.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $17.80 / $21.98	Professional	26	$16.98	$17.80	$21.98
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.51 / $95.15 / $157.27	Professional		$18.51	$95.15	$157.27
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $20.75 / $21.28	Professional	26	$19.82	$20.75	$21.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.60 / $134.83 / $157.30	Professional		$123.60	$134.83	$157.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.28 / $17.76 / $20.72	Professional	26	$16.28	$17.76	$20.72
United Facility/Professional Professional Modifier Low / Median / High Price $48.06 / $151.28 / $151.69	Professional		$48.06	$151.28	$151.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $19.98 / $23.36	Professional	26	$8.60	$19.98	$23.36
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $93.48 / $139.28 / $187.91	Professional		$93.48	$139.28	$187.91
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $22.31 / $38.40	Professional	26	$15.30	$22.31	$38.40