Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.77 / $105.13 / $123.69	Facility	26	$92.77	$105.13	$123.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.59 / $99.59 / $99.59	Professional		$99.59	$99.59	$99.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.81 / $35.81 / $35.81	Professional	TC	$35.81	$35.81	$35.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.65 / $203.96 / $214.44	Professional		$128.65	$203.96	$214.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.01 / $80.27 / $104.76	Professional	TC	$47.01	$80.27	$104.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $118.39 / $197.18 / $275.69	Professional		$118.39	$197.18	$275.69
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $137.66 / $144.15 / $144.15	Professional	TC	$137.66	$144.15	$144.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.61 / $181.30 / $211.51	Professional		$155.61	$181.30	$211.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $94.37 / $109.94 / $128.27	Professional	26	$94.37	$109.94	$128.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.24 / $71.34 / $74.33	Professional	TC	$61.24	$71.34	$74.33
United Facility/Professional Professional Modifier Low / Median / High Price $203.96 / $230.59 / $244.62	Professional		$203.96	$230.59	$244.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.27 / $88.65 / $106.92	Professional	TC	$80.27	$88.65	$106.92
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $178.58 / $236.36 / $382.20	Professional		$178.58	$236.36	$382.20
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $68.06 / $99.47 / $169.79	Professional	TC	$68.06	$99.47	$169.79