Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $308.33 / $357.93 / $411.76	Professional		$308.33	$357.93	$411.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.54 / $119.71 / $560.00	Professional	26	$103.54	$119.71	$560.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.24 / $313.12 / $734.14	Professional		$217.24	$313.12	$734.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $99.78 / $129.43 / $257.91	Professional	26	$99.78	$129.43	$257.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $164.88 / $379.95 / $454.00	Professional		$164.88	$379.95	$454.00
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $174.96 / $183.20 / $187.78	Professional	26	$174.96	$183.20	$187.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.67 / $295.27 / $344.48	Professional		$270.67	$295.27	$344.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $113.89 / $124.25 / $144.96	Professional	26	$113.89	$124.25	$144.96
United Facility/Professional Professional Modifier Low / Median / High Price $250.98 / $307.58 / $410.87	Professional		$250.98	$307.58	$410.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $80.00 / $129.43 / $173.61	Professional	26	$80.00	$129.43	$173.61
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $232.82 / $317.81 / $838.90	Professional		$232.82	$317.81	$838.90
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $98.38 / $134.26 / $229.16	Professional	26	$98.38	$134.26	$229.16