Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $337.88 / $337.88 / $764.81	Professional		$337.88	$337.88	$764.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $163.69 / $260.95 / $266.89	Professional	26	$163.69	$260.95	$266.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $212.43 / $212.43 / $544.17	Professional	TC	$212.43	$212.43	$544.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $577.75 / $577.75 / $577.75	Professional		$577.75	$577.75	$577.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $176.38 / $176.38 / $176.38	Professional	26	$176.38	$176.38	$176.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $401.38 / $401.38 / $401.38	Professional	TC	$401.38	$401.38	$401.38
HMSA Facility/Professional Professional Modifier Low / Median / High Price $144.51 / $524.79 / $617.80	Professional		$144.51	$524.79	$617.80
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $162.36 / $170.01 / $243.07	Professional	26	$162.36	$170.01	$243.07
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $336.36 / $352.21 / $374.74	Professional	TC	$336.36	$352.21	$374.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $508.42 / $554.64 / $647.08	Professional		$508.42	$554.64	$647.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $155.21 / $169.32 / $197.54	Professional	26	$155.21	$169.32	$197.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $353.21 / $385.32 / $449.54	Professional	TC	$353.21	$385.32	$449.54
United Facility/Professional Professional Modifier Low / Median / High Price $577.75 / $577.75 / $710.80	Professional		$577.75	$577.75	$710.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.00 / $239.69 / $729.41	Professional	26	$95.00	$239.69	$729.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $401.38 / $401.38 / $471.11	Professional	TC	$401.38	$401.38	$471.11
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $249.04 / $539.04 / $793.40	Professional		$249.04	$539.04	$793.40
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $136.02 / $189.55 / $284.69	Professional	26	$136.02	$189.55	$284.69
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $104.36 / $315.69 / $508.71	Professional	TC	$104.36	$315.69	$508.71