Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $79.43 / $93.33	Facility	26	$70.79	$79.43	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $501.19 / $602.56	Professional		$371.54	$501.19	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $141.25	Professional	26	$85.11	$104.71	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $501.19 / $616.60	Professional		$380.19	$501.19	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $91.20 / $104.71	Professional	26	$66.07	$91.20	$104.71
HMSA Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $741.31 / $812.83	Professional		$512.86	$741.31	$812.83
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $97.72 / $100.00	Professional	26	$93.33	$97.72	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $575.44 / $724.44	Professional		$524.81	$575.44	$724.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $87.10 / $107.15	Professional	26	$79.43	$87.10	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $616.60 / $794.33	Professional		$524.81	$616.60	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $93.33 / $114.82	Professional	26	$79.43	$93.33	$114.82
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $707.95 / $1,047.13	Professional		$501.19	$707.95	$1,047.13
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $104.71 / $177.83	Professional	26	$81.28	$104.71	$177.83