Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.26 / $52.43 / $61.68	Facility	26	$46.26	$52.43	$61.68
HMSA Facility/Professional Professional Modifier Low / Median / High Price $54.34 / $210.73 / $220.66	Professional		$54.34	$210.73	$220.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $57.66 / $60.38 / $61.88	Professional	26	$57.66	$60.38	$61.88
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $153.07 / $160.28 / $160.28	Professional	TC	$153.07	$160.28	$160.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.85 / $153.61 / $179.21	Professional		$131.85	$153.61	$179.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.06 / $54.83 / $63.97	Professional	26	$47.06	$54.83	$63.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.79 / $98.78 / $102.90	Professional	TC	$84.79	$98.78	$102.90
United Facility/Professional Professional Modifier Low / Median / High Price $172.81 / $195.22 / $236.99	Professional		$172.81	$195.22	$236.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.71 / $61.68 / $68.26	Professional	26	$52.71	$61.68	$68.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.17 / $111.13 / $184.28	Professional	TC	$76.17	$111.13	$184.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $158.60 / $202.10 / $356.08	Professional		$158.60	$202.10	$356.08
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $44.05 / $67.00 / $107.59	Professional	26	$44.05	$67.00	$107.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $106.90 / $131.43 / $279.06	Professional	TC	$106.90	$131.43	$279.06