Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.76 / $89.26 / $105.02	Facility	26	$78.76	$89.26	$105.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $196.11 / $389.95 / $1,281.00	Professional		$196.11	$389.95	$1,281.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.24 / $90.24 / $90.24	Facility	26	$90.24	$90.24	$90.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.83 / $317.61 / $679.22	Professional		$178.83	$317.61	$679.22
HMSA Facility/Professional Professional Modifier Low / Median / High Price $98.96 / $149.61 / $417.40	Professional		$98.96	$149.61	$417.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $303.25 / $330.82 / $385.95	Professional		$303.25	$330.82	$385.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $93.35 / $108.91	Professional	26	$85.57	$93.35	$108.91
United Facility/Professional Professional Modifier Low / Median / High Price $252.27 / $372.17 / $463.11	Professional		$252.27	$372.17	$463.11
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $212.89 / $350.61 / $727.12	Professional		$212.89	$350.61	$727.12