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 $173.43 / $259.02 / $1,158.54	Professional		$173.43	$259.02	$1,158.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.76 / $125.22 / $562.00	Professional	26	$81.76	$125.22	$562.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.92 / $102.92 / $102.92	Facility	26	$102.92	$102.92	$102.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.77 / $252.77 / $425.33	Professional		$139.77	$252.77	$425.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.88 / $112.88 / $208.67	Professional	26	$72.88	$112.88	$208.67
HMSA Facility/Professional Professional Modifier Low / Median / High Price $128.53 / $267.24 / $363.92	Professional		$128.53	$267.24	$363.92
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $137.63 / $144.13 / $147.74	Professional	26	$137.63	$144.13	$147.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.96 / $224.69 / $262.14	Professional		$205.96	$224.69	$262.14
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 $189.58 / $252.77 / $293.91	Professional		$189.58	$252.77	$293.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $90.44 / $120.58 / $150.15	Professional	26	$90.44	$120.58	$150.15
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $199.97 / $303.94 / $491.89	Professional		$199.97	$303.94	$491.89
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $92.04 / $135.03 / $234.88	Professional	26	$92.04	$135.03	$234.88