Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.19 / $122.61 / $144.25	Facility	26	$108.19	$122.61	$144.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.54 / $468.27 / $1,048.63	Professional		$298.54	$468.27	$1,048.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $146.35 / $356.11	Professional	26	$90.71	$146.35	$356.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $227.58 / $367.81 / $560.37	Professional	TC	$227.58	$367.81	$560.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $345.09 / $470.37 / $590.53	Professional		$345.09	$470.37	$590.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.86 / $116.89 / $144.25	Professional	26	$80.86	$116.89	$144.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.23 / $353.48 / $446.28	Professional	TC	$264.23	$353.48	$446.28
HMSA Facility/Professional Professional Modifier Low / Median / High Price $127.82 / $580.92 / $631.28	Professional		$127.82	$580.92	$631.28
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $135.63 / $142.02 / $145.57	Professional	26	$135.63	$142.02	$145.57
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $445.30 / $466.28 / $485.71	Professional	TC	$445.30	$466.28	$485.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $450.55 / $524.91 / $612.40	Professional		$450.55	$524.91	$612.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $110.06 / $128.22 / $149.59	Professional	26	$110.06	$128.22	$149.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $340.50 / $396.70 / $413.23	Professional	TC	$340.50	$396.70	$413.23
United Facility/Professional Professional Modifier Low / Median / High Price $590.53 / $594.69 / $772.66	Professional		$590.53	$594.69	$772.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $142.88 / $144.25 / $170.27	Professional	26	$142.88	$144.25	$170.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $446.28 / $451.81 / $602.39	Professional	TC	$446.28	$451.81	$602.39
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $542.09 / $671.41 / $1,249.29	Professional		$542.09	$671.41	$1,249.29
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $132.16 / $157.82 / $266.45	Professional	26	$132.16	$157.82	$266.45
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $409.92 / $522.07 / $996.38	Professional	TC	$409.92	$522.07	$996.38