Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.98 / $209.52 / $375.94	Professional		$117.98	$209.52	$375.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $90.10 / $90.10	Professional	26	$36.95	$90.10	$90.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.01 / $81.01 / $254.87	Professional	TC	$81.01	$81.01	$254.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.08 / $235.08 / $235.08	Professional		$235.08	$235.08	$235.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.15 / $47.15 / $47.15	Professional	26	$47.15	$47.15	$47.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $187.91 / $187.91 / $187.91	Professional	TC	$187.91	$187.91	$187.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $232.29 / $291.55	Professional		$53.87	$232.29	$291.55
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $60.53 / $63.38 / $97.25	Professional	26	$60.53	$63.38	$97.25
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $159.77 / $167.30 / $194.29	Professional	TC	$159.77	$167.30	$194.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.87 / $225.67 / $263.27	Professional		$206.87	$225.67	$263.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $45.26 / $52.81	Professional	26	$41.49	$45.26	$52.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $165.36 / $180.40 / $210.46	Professional	TC	$165.36	$180.40	$210.46
United Facility/Professional Professional Modifier Low / Median / High Price $235.08 / $235.08 / $294.70	Professional		$235.08	$235.08	$294.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.15 / $47.15 / $62.72	Professional	26	$47.15	$47.15	$62.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $187.91 / $187.91 / $231.98	Professional	TC	$187.91	$187.91	$231.98
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $169.33 / $253.75 / $418.12	Professional		$169.33	$253.75	$418.12
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $46.96 / $56.21 / $86.04	Professional	26	$46.96	$56.21	$86.04
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $147.26 / $202.95 / $332.08	Professional	TC	$147.26	$202.95	$332.08