Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.19 / $216.19 / $710.82	Professional		$216.19	$216.19	$710.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.58 / $147.05 / $147.05	Professional	26	$59.58	$147.05	$147.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $156.60 / $156.60 / $613.94	Professional	TC	$156.60	$156.60	$613.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $530.91 / $530.91 / $530.91	Professional		$530.91	$530.91	$530.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.20 / $78.20 / $78.20	Professional	26	$78.20	$78.20	$78.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $452.71 / $452.71 / $452.71	Professional	TC	$452.71	$452.71	$452.71
HMSA Facility/Professional Professional Modifier Low / Median / High Price $74.72 / $79.12 / $531.52	Professional		$74.72	$79.12	$531.52
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $83.95 / $87.91 / $90.10	Professional	26	$83.95	$87.91	$90.10
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $411.26 / $430.64 / $441.41	Professional	TC	$411.26	$430.64	$441.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.20 / $509.68 / $594.62	Professional		$467.20	$509.68	$594.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.81 / $75.06 / $87.58	Professional	26	$68.81	$75.06	$87.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $398.39 / $434.60 / $507.04	Professional	TC	$398.39	$434.60	$507.04
United Facility/Professional Professional Modifier Low / Median / High Price $530.91 / $530.91 / $695.08	Professional		$530.91	$530.91	$695.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $78.20 / $78.20 / $104.81	Professional	26	$78.20	$78.20	$104.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $452.71 / $452.71 / $590.27	Professional	TC	$452.71	$452.71	$590.27
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $313.08 / $573.14 / $990.70	Professional		$313.08	$573.14	$990.70
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $77.89 / $91.73 / $142.43	Professional	26	$77.89	$91.73	$142.43
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $224.73 / $488.93 / $848.27	Professional	TC	$224.73	$488.93	$848.27