Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.18 / $56.87 / $66.91	Facility	26	$50.18	$56.87	$66.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.20 / $172.58 / $622.00	Professional		$110.20	$172.58	$622.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.04 / $57.04 / $57.04	Facility	26	$57.04	$57.04	$57.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.84 / $147.32 / $289.83	Professional		$92.84	$147.32	$289.83
HMSA Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $118.19 / $167.51	Professional		$62.75	$118.19	$167.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.93 / $151.56 / $176.82	Professional		$138.93	$151.56	$176.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.52 / $59.47 / $69.38	Professional	26	$54.52	$59.47	$69.38
United Facility/Professional Professional Modifier Low / Median / High Price $120.18 / $170.51 / $197.03	Professional		$120.18	$170.51	$197.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $186.10 / $316.55	Professional		$130.81	$186.10	$316.55