Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.81 / $109.71 / $129.07	Facility	26	$96.81	$109.71	$129.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $684.86 / $684.86 / $684.86	Professional		$684.86	$684.86	$684.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $611.46 / $611.46 / $611.46	Professional	TC	$611.46	$611.46	$611.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $279.27 / $496.97 / $1,392.93	Professional		$279.27	$496.97	$1,392.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.43 / $399.14 / $1,263.85	Professional	TC	$162.43	$399.14	$1,263.85
HMSA Facility/Professional Professional Modifier Low / Median / High Price $126.95 / $663.38 / $1,487.86	Professional		$126.95	$663.38	$1,487.86
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $1,289.49 / $1,350.25 / $1,552.80	Professional	TC	$1,289.49	$1,350.25	$1,552.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,062.75 / $1,238.16 / $1,444.52	Professional		$1,062.75	$1,238.16	$1,444.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $98.48 / $114.73 / $133.85	Professional	26	$98.48	$114.73	$133.85
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $964.28 / $1,123.43 / $1,170.24	Professional	TC	$964.28	$1,123.43	$1,170.24
United Facility/Professional Professional Modifier Low / Median / High Price $680.91 / $1,392.93 / $1,462.83	Professional		$680.91	$1,392.93	$1,462.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $552.79 / $1,263.85 / $1,302.90	Professional	TC	$552.79	$1,263.85	$1,302.90
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $385.22 / $1,107.68 / $2,018.27	Professional		$385.22	$1,107.68	$2,018.27
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $234.63 / $916.64 / $1,779.28	Professional	TC	$234.63	$916.64	$1,779.28