Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.48 / $342.74 / $342.74	Professional		$340.48	$342.74	$342.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.95 / $112.50 / $112.50	Professional	26	$109.95	$112.50	$112.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.24 / $230.24 / $230.53	Professional	TC	$230.24	$230.24	$230.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.39 / $455.91 / $455.91	Professional		$319.39	$455.91	$455.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.78 / $127.48 / $196.82	Professional	26	$105.78	$127.48	$196.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.62 / $328.45 / $444.04	Professional	TC	$213.62	$328.45	$444.04
HMSA Facility/Professional Professional Modifier Low / Median / High Price $156.97 / $542.83 / $617.04	Professional		$156.97	$542.83	$617.04
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $164.06 / $176.36 / $184.67	Professional	26	$164.06	$176.36	$184.67
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $480.38 / $516.41 / $540.74	Professional	TC	$480.38	$516.41	$540.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $401.20 / $437.68 / $510.62	Professional		$401.20	$437.68	$510.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.18 / $122.38 / $142.77	Professional	26	$112.18	$122.38	$142.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $289.04 / $315.31 / $367.86	Professional	TC	$289.04	$315.31	$367.86
United Facility/Professional Professional Modifier Low / Median / High Price $372.02 / $455.91 / $589.88	Professional		$372.02	$455.91	$589.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.02 / $130.06 / $169.29	Professional	26	$104.02	$130.06	$169.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.02 / $328.45 / $420.59	Professional	TC	$268.02	$328.45	$420.59
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $358.42 / $539.74	Professional		$67.47	$358.42	$539.74
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.39 / $92.41 / $139.16	Professional	26	$17.39	$92.41	$139.16
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $50.07 / $266.01 / $400.58	Professional	TC	$50.07	$266.01	$400.58