Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.35 / $113.35 / $113.35	Professional		$113.35	$113.35	$113.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $31.13 / $31.13	Professional	26	$31.13	$31.13	$31.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.23 / $82.23 / $82.23	Professional	TC	$82.23	$82.23	$82.23
HMSA Facility/Professional Professional Modifier Low / Median / High Price $31.61 / $92.76 / $111.83	Professional		$31.61	$92.76	$111.83
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $35.52 / $37.19 / $53.25	Professional	26	$35.52	$37.19	$53.25
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $52.88 / $55.37 / $58.59	Professional	TC	$52.88	$55.37	$58.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $99.75 / $108.82 / $126.95	Professional		$99.75	$108.82	$126.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.39 / $29.88 / $34.86	Professional	26	$27.39	$29.88	$34.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.36 / $78.94 / $92.09	Professional	TC	$72.36	$78.94	$92.09
United Facility/Professional Professional Modifier Low / Median / High Price $113.35 / $113.35 / $115.25	Professional		$113.35	$113.35	$115.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.13 / $31.13 / $41.21	Professional	26	$31.13	$31.13	$41.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $74.04 / $74.04 / $82.23	Professional	TC	$74.04	$74.04	$82.23
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $59.42 / $97.72 / $133.19	Professional		$59.42	$97.72	$133.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $23.30 / $35.09 / $47.81	Professional	26	$23.30	$35.09	$47.81
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $30.87 / $59.50 / $96.70	Professional	TC	$30.87	$59.50	$96.70