Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.02 / $236.34 / $357.59	Professional		$184.02	$236.34	$357.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $34.64 / $47.49	Professional	26	$34.64	$34.64	$47.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.52 / $136.52 / $322.94	Professional	TC	$136.52	$136.52	$322.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.45 / $266.45 / $266.45	Professional		$266.45	$266.45	$266.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $28.16 / $28.16	Professional	26	$28.16	$28.16	$28.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $238.30 / $238.30 / $238.30	Professional	TC	$238.30	$238.30	$238.30
HMSA Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $66.06 / $290.49	Professional		$62.39	$66.06	$290.49
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $70.09 / $73.40 / $75.23	Professional	26	$70.09	$73.40	$75.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $205.14 / $214.81 / $214.81	Professional	TC	$205.14	$214.81	$214.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $234.49 / $255.80 / $298.44	Professional		$234.49	$255.80	$298.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $27.04 / $31.54	Professional	26	$24.78	$27.04	$31.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $209.70 / $228.77 / $266.89	Professional	TC	$209.70	$228.77	$266.89
United Facility/Professional Professional Modifier Low / Median / High Price $266.45 / $266.45 / $308.95	Professional		$266.45	$266.45	$308.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.16 / $95.00 / $95.00	Professional	26	$28.16	$95.00	$95.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $238.30 / $238.30 / $268.58	Professional	TC	$238.30	$238.30	$268.58
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $244.69 / $313.26 / $412.02	Professional		$244.69	$313.26	$412.02
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $29.13 / $34.49 / $71.17	Professional	26	$29.13	$34.49	$71.17
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $197.16 / $271.67 / $322.29	Professional	TC	$197.16	$271.67	$322.29