Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $472.48 / $472.48 / $472.48	Professional		$472.48	$472.48	$472.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $310.63 / $310.63 / $310.63	Professional		$310.63	$310.63	$310.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $146.88 / $146.88 / $146.88	Professional	26	$146.88	$146.88	$146.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.74 / $163.74 / $163.74	Professional	TC	$163.74	$163.74	$163.74
HMSA Facility/Professional Professional Modifier Low / Median / High Price $115.14 / $121.91 / $357.62	Professional		$115.14	$121.91	$357.62
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $206.95 / $216.70 / $222.11	Professional	26	$206.95	$216.70	$222.11
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $129.36 / $135.46 / $135.46	Professional	TC	$129.36	$135.46	$135.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.35 / $298.20 / $347.90	Professional		$273.35	$298.20	$347.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $129.26 / $141.01 / $164.51	Professional	26	$129.26	$141.01	$164.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.09 / $157.19 / $183.39	Professional	TC	$144.09	$157.19	$183.39
United Facility/Professional Professional Modifier Low / Median / High Price $310.63 / $310.63 / $388.84	Professional		$310.63	$310.63	$388.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $146.88 / $146.88 / $207.50	Professional	26	$146.88	$146.88	$207.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.74 / $163.74 / $181.34	Professional	TC	$163.74	$163.74	$181.34
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $250.95 / $365.52 / $559.46	Professional		$250.95	$365.52	$559.46
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $121.10 / $196.04 / $275.47	Professional	26	$121.10	$196.04	$275.47
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $76.90 / $176.84 / $295.16	Professional	TC	$76.90	$176.84	$295.16