Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $30.90 / $36.31	Facility	26	$26.92	$30.90	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $199.53	Professional		$83.18	$128.82	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $223.87	Professional		$89.13	$123.03	$223.87
HMSA Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $204.17 / $223.87	Professional		$42.66	$204.17	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $208.93	Professional		$162.18	$177.83	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $33.11 / $38.90	Professional	26	$30.20	$33.11	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $257.04	Professional		$128.82	$162.18	$257.04
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $257.04	Professional		$131.83	$190.55	$257.04