Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.44 / $102.49 / $120.58	Facility	26	$90.44	$102.49	$120.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.12 / $225.80 / $275.14	Professional		$114.12	$225.80	$275.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.16 / $77.76 / $90.82	Professional	26	$67.16	$77.76	$90.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.81 / $106.81 / $106.81	Facility	26	$106.81	$106.81	$106.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.67 / $372.83 / $779.58	Professional		$184.67	$372.83	$779.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.57 / $105.07 / $130.51	Professional	26	$96.57	$105.07	$130.51
HMSA Facility/Professional Professional Modifier Low / Median / High Price $110.92 / $791.10 / $6,352.00	Professional		$110.92	$791.10	$6,352.00
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $118.78 / $124.38 / $127.49	Professional	26	$118.78	$124.38	$127.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.91 / $191.90 / $223.89	Professional		$175.91	$191.90	$223.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $98.25 / $107.18 / $125.05	Professional	26	$98.25	$107.18	$125.05
United Facility/Professional Professional Modifier Low / Median / High Price $95.75 / $215.89 / $277.54	Professional		$95.75	$215.89	$277.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.85 / $120.58 / $151.46	Professional	26	$56.85	$120.58	$151.46
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $197.98 / $280.67 / $877.48	Professional		$197.98	$280.67	$877.48
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $84.45 / $131.97 / $207.81	Professional	26	$84.45	$131.97	$207.81