Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.00 / $348.07 / $361.71	Professional		$288.00	$348.07	$361.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.67 / $91.49 / $92.39	Professional	26	$87.67	$91.49	$92.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.28 / $256.58 / $269.31	Professional	TC	$200.28	$256.58	$269.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.01 / $371.95 / $371.95	Professional		$270.01	$371.95	$371.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.41 / $102.04 / $154.71	Professional	26	$84.41	$102.04	$154.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $185.60 / $269.91 / $381.93	Professional	TC	$185.60	$269.91	$381.93
HMSA Facility/Professional Professional Modifier Low / Median / High Price $160.72 / $513.97 / $2,077.00	Professional		$160.72	$513.97	$2,077.00
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $158.65 / $170.55 / $178.59	Professional	26	$158.65	$170.55	$178.59
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $454.84 / $488.95 / $511.99	Professional	TC	$454.84	$488.95	$511.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.32 / $357.07 / $416.58	Professional		$327.32	$357.07	$416.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.79 / $97.96 / $114.28	Professional	26	$89.79	$97.96	$114.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $237.52 / $259.12 / $302.30	Professional	TC	$237.52	$259.12	$302.30
United Facility/Professional Professional Modifier Low / Median / High Price $367.44 / $371.95 / $492.84	Professional		$367.44	$371.95	$492.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $83.26 / $102.61 / $134.19	Professional	26	$83.26	$102.61	$134.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.25 / $269.91 / $358.65	Professional	TC	$220.25	$269.91	$358.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $55.98 / $418.28 / $3,113.00	Professional		$55.98	$418.28	$3,113.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.88 / $95.88 / $153.00	Professional	26	$13.88	$95.88	$153.00
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $42.10 / $299.95 / $486.46	Professional	TC	$42.10	$299.95	$486.46