Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.12 / $194.12 / $258.08	Professional		$194.12	$194.12	$258.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.35 / $71.55 / $205.70	Professional	26	$49.35	$71.55	$205.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.75 / $144.75 / $204.02	Professional	TC	$144.75	$144.75	$204.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $146.80 / $146.80	Professional		$146.80	$146.80	$146.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.96 / $39.96 / $39.96	Professional	26	$39.96	$39.96	$39.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.84 / $106.84 / $106.84	Professional	TC	$106.84	$106.84	$106.84
HMSA Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $197.96 / $296.06	Professional		$81.34	$197.96	$296.06
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $91.40 / $95.71 / $98.11	Professional	26	$91.40	$95.71	$98.11
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $189.05 / $197.96 / $197.96	Professional	TC	$189.05	$197.96	$197.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.18 / $140.93 / $164.42	Professional		$129.18	$140.93	$164.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $38.36 / $44.76	Professional	26	$35.17	$38.36	$44.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.02 / $102.56 / $119.66	Professional	TC	$94.02	$102.56	$119.66
United Facility/Professional Professional Modifier Low / Median / High Price $146.80 / $146.80 / $191.57	Professional		$146.80	$146.80	$191.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.96 / $39.96 / $55.59	Professional	26	$39.96	$39.96	$55.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.84 / $106.84 / $135.97	Professional	TC	$106.84	$106.84	$135.97
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $142.96 / $274.92 / $430.47	Professional		$142.96	$274.92	$430.47
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $39.03 / $67.34 / $110.84	Professional	26	$39.03	$67.34	$110.84
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $103.92 / $183.71 / $322.72	Professional	TC	$103.92	$183.71	$322.72