Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $232.05 / $263.00 / $309.41	Facility	26	$232.05	$263.00	$309.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $447.94 / $596.72 / $2,233.50	Professional		$447.94	$596.72	$2,233.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $198.28 / $314.12 / $803.18	Professional	26	$198.28	$314.12	$803.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $293.89 / $376.22 / $487.45	Professional	TC	$293.89	$376.22	$487.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $417.34 / $697.96 / $1,369.28	Professional		$417.34	$697.96	$1,369.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $184.37 / $252.80 / $309.41	Professional	26	$184.37	$252.80	$309.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $232.97 / $388.56 / $1,116.49	Professional	TC	$232.97	$388.56	$1,116.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $267.08 / $1,782.61 / $2,032.39	Professional		$267.08	$1,782.61	$2,032.39
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $283.42 / $296.77 / $304.20	Professional	26	$283.42	$296.77	$304.20
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $1,418.98 / $1,485.84 / $1,491.35	Professional	TC	$1,418.98	$1,485.84	$1,491.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $532.52 / $620.41 / $723.81	Professional		$532.52	$620.41	$723.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $236.07 / $275.02 / $320.87	Professional	26	$236.07	$275.02	$320.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $296.45 / $345.38 / $359.78	Professional	TC	$296.45	$345.38	$359.78
United Facility/Professional Professional Modifier Low / Median / High Price $697.96 / $816.91 / $1,190.35	Professional		$697.96	$816.91	$1,190.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $282.32 / $309.41 / $362.72	Professional	26	$282.32	$309.41	$362.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $388.56 / $454.19 / $908.04	Professional	TC	$388.56	$454.19	$908.04
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $584.72 / $876.81 / $1,922.20	Professional		$584.72	$876.81	$1,922.20
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $247.22 / $336.10 / $543.10	Professional	26	$247.22	$336.10	$543.10
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $337.50 / $487.49 / $1,598.94	Professional	TC	$337.50	$487.49	$1,598.94