Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $380.19 / $501.19	Professional		$338.84	$380.19	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $138.04	Professional	26	$107.15	$112.20	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $251.19 / $371.54	Professional	TC	$229.09	$251.19	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $354.81 / $457.09	Professional		$316.23	$354.81	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $128.82 / $194.98	Professional	26	$104.71	$128.82	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $223.87 / $446.68	Professional	TC	$213.80	$223.87	$446.68
HMSA Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $588.84 / $616.60	Professional		$489.78	$588.84	$616.60
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $169.82 / $186.21	Professional	26	$165.96	$169.82	$186.21
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $501.19 / $537.03	Professional	TC	$478.63	$501.19	$537.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $436.52 / $537.03	Professional		$398.11	$436.52	$537.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $128.82 / $158.49	Professional	26	$117.49	$128.82	$158.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $309.03 / $380.19	Professional	TC	$281.84	$309.03	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $416.87 / $588.84	Professional		$371.54	$416.87	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $169.82	Professional	26	$104.71	$138.04	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $288.40 / $416.87	Professional	TC	$251.19	$288.40	$416.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $354.81 / $537.03	Professional		$67.61	$354.81	$537.03
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $93.33 / $138.04	Professional	26	$17.38	$93.33	$138.04
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $263.03 / $398.11	Professional	TC	$50.12	$263.03	$398.11