Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.13 / $63.62 / $74.84	Facility	26	$56.13	$63.62	$74.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.87 / $195.72 / $753.00	Professional		$113.87	$195.72	$753.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.00 / $64.00 / $64.00	Facility	26	$64.00	$64.00	$64.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.04 / $152.88 / $285.33	Professional		$91.04	$152.88	$285.33
HMSA Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $132.00 / $187.05	Professional		$69.98	$132.00	$187.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.91 / $143.90 / $167.89	Professional		$131.91	$143.90	$167.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.98 / $66.53 / $77.62	Professional	26	$60.98	$66.53	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $121.42 / $161.88 / $201.37	Professional		$121.42	$161.88	$201.37
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $148.50 / $193.42 / $311.19	Professional		$148.50	$193.42	$311.19