Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $467.96 / $467.96 / $1,037.32	Professional		$467.96	$467.96	$1,037.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.29 / $46.29 / $88.04	Professional	26	$46.29	$46.29	$88.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $421.65 / $421.65 / $949.29	Professional	TC	$421.65	$421.65	$949.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $770.68 / $770.68 / $770.68	Professional		$770.68	$770.68	$770.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.81 / $70.81 / $70.81	Professional	26	$70.81	$70.81	$70.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $699.86 / $699.86 / $699.86	Professional	TC	$699.86	$699.86	$699.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $68.27 / $765.26	Professional		$64.48	$68.27	$765.26
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $72.45 / $75.86 / $77.76	Professional	26	$72.45	$75.86	$77.76
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $656.54 / $687.48 / $687.48	Professional	TC	$656.54	$687.48	$687.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $678.19 / $739.85 / $863.16	Professional		$678.19	$739.85	$863.16
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.32 / $67.98 / $79.31	Professional	26	$62.32	$67.98	$79.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $615.88 / $671.87 / $783.85	Professional	TC	$615.88	$671.87	$783.85
United Facility/Professional Professional Modifier Low / Median / High Price $770.68 / $770.68 / $1,001.27	Professional		$770.68	$770.68	$1,001.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.03 / $70.81 / $93.92	Professional	26	$35.03	$70.81	$93.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $699.86 / $699.86 / $907.35	Professional	TC	$699.86	$699.86	$907.35
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $508.03 / $892.75 / $1,503.99	Professional		$508.03	$892.75	$1,503.99
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $49.89 / $76.26 / $130.52	Professional	26	$49.89	$76.26	$130.52
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $458.13 / $816.99 / $1,373.47	Professional	TC	$458.13	$816.99	$1,373.47