Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $557.95 / $557.95 / $557.95	Professional		$557.95	$557.95	$557.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $59.00 / $59.00	Professional	26	$59.00	$59.00	$59.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $498.95 / $498.95 / $498.95	Professional	TC	$498.95	$498.95	$498.95
HMSA Facility/Professional Professional Modifier Low / Median / High Price $57.55 / $571.57 / $640.96	Professional		$57.55	$571.57	$640.96
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $64.65 / $67.70 / $69.40	Professional	26	$64.65	$67.70	$69.40
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $545.85 / $571.57 / $571.57	Professional	TC	$545.85	$571.57	$571.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $491.00 / $535.63 / $624.90	Professional		$491.00	$535.63	$624.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.92 / $56.64 / $66.08	Professional	26	$51.92	$56.64	$66.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $439.08 / $478.99 / $558.82	Professional	TC	$439.08	$478.99	$558.82
United Facility/Professional Professional Modifier Low / Median / High Price $557.95 / $557.95 / $764.60	Professional		$557.95	$557.95	$764.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.00 / $59.00 / $79.31	Professional	26	$59.00	$59.00	$79.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $498.95 / $498.95 / $685.29	Professional	TC	$498.95	$498.95	$685.29
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $438.24 / $628.00 / $1,055.48	Professional		$438.24	$628.00	$1,055.48
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $63.54 / $94.89	Professional	26	$44.59	$63.54	$94.89
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $393.65 / $565.44 / $947.57	Professional	TC	$393.65	$565.44	$947.57