Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $343.80 / $343.80 / $352.43	Facility		$343.80	$343.80	$352.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.01 / $199.83 / $460.83	Professional		$38.01	$199.83	$460.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.49 / $77.98 / $82.17	Professional	26	$48.49	$77.98	$82.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.11 / $134.06 / $150.03	Professional	TC	$40.11	$134.06	$150.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $241.66 / $332.31	Professional		$67.73	$241.66	$332.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $94.11 / $118.55	Professional	26	$36.47	$94.11	$118.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.27 / $147.55 / $213.87	Professional	TC	$31.27	$147.55	$213.87
HMSA Facility/Professional Professional Modifier Low / Median / High Price $104.40 / $285.08 / $342.51	Professional		$104.40	$285.08	$342.51
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $109.11 / $117.29 / $122.82	Professional	26	$109.11	$117.29	$122.82
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $195.18 / $209.82 / $219.71	Professional	TC	$195.18	$209.82	$219.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $79.69 / $92.97	Professional		$73.05	$79.69	$92.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.34 / $42.91 / $50.06	Professional	26	$39.34	$42.91	$50.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.72 / $36.79 / $42.92	Professional	TC	$33.72	$36.79	$42.92
United Facility/Professional Facility Modifier Low / Median / High Price $1,078.00 / $1,078.00 / $1,078.00	Facility		$1,078.00	$1,078.00	$1,078.00
United Facility/Professional Professional Modifier Low / Median / High Price $67.73 / $83.01 / $110.87	Professional		$67.73	$83.01	$110.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $44.70 / $60.36	Professional	26	$36.47	$44.70	$60.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.53 / $36.97 / $50.51	Professional	TC	$29.53	$36.97	$50.51
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $62.82 / $2,370.61 / $4,023.00	Professional		$62.82	$2,370.61	$4,023.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $51.10 / $137.02	Professional	26	$6.44	$51.10	$137.02
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $5.39 / $42.76 / $244.67	Professional	TC	$5.39	$42.76	$244.67