Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.50 / $209.50 / $500.04	Professional		$209.50	$209.50	$500.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.85 / $47.82 / $680.00	Professional	26	$41.85	$47.82	$680.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.31 / $168.31 / $437.87	Professional	TC	$168.31	$168.31	$437.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.24 / $373.24 / $373.24	Professional		$373.24	$373.24	$373.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Professional	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $322.88 / $322.88 / $322.88	Professional	TC	$322.88	$322.88	$322.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $51.58 / $54.61 / $440.44	Professional		$51.58	$54.61	$440.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $57.95 / $60.68 / $62.20	Professional	26	$57.95	$60.68	$62.20
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $352.40 / $369.01 / $378.24	Professional	TC	$352.40	$369.01	$378.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.45 / $358.31 / $418.03	Professional		$328.45	$358.31	$418.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.33 / $48.36 / $56.42	Professional	26	$44.33	$48.36	$56.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $284.13 / $309.95 / $361.62	Professional	TC	$284.13	$309.95	$361.62
United Facility/Professional Professional Modifier Low / Median / High Price $373.24 / $373.24 / $590.14	Professional		$373.24	$373.24	$590.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.38 / $50.38 / $72.05	Professional	26	$50.38	$50.38	$72.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $322.88 / $322.88 / $518.09	Professional	TC	$322.88	$322.88	$518.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $300.17 / $438.75 / $759.96	Professional		$300.17	$438.75	$759.96
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $51.62 / $60.54 / $95.42	Professional	26	$51.62	$60.54	$95.42
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $239.63 / $379.70 / $664.54	Professional	TC	$239.63	$379.70	$664.54