Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.77 / $290.32 / $1,234.08	Professional		$229.77	$290.32	$1,234.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.78 / $71.45 / $351.00	Professional	26	$62.78	$71.45	$351.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.77 / $182.65 / $774.00	Professional	TC	$159.77	$182.65	$774.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.50 / $69.50 / $69.50	Facility	26	$69.50	$69.50	$69.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.93 / $290.14 / $587.82	Professional		$199.93	$290.14	$587.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $74.84 / $136.72	Professional	26	$57.72	$74.84	$136.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.21 / $205.89 / $451.10	Professional	TC	$142.21	$205.89	$451.10
HMSA Facility/Professional Professional Modifier Low / Median / High Price $98.73 / $419.11 / $488.76	Professional		$98.73	$419.11	$488.76
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $102.20 / $107.02 / $109.70	Professional	26	$102.20	$107.02	$109.70
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $316.91 / $331.84 / $331.84	Professional	TC	$316.91	$331.84	$331.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $255.33 / $278.54 / $324.97	Professional		$255.33	$278.54	$324.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.86 / $71.84 / $83.82	Professional	26	$65.86	$71.84	$83.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $189.48 / $206.70 / $241.15	Professional	TC	$189.48	$206.70	$241.15
United Facility/Professional Professional Modifier Low / Median / High Price $236.76 / $290.14 / $395.90	Professional		$236.76	$290.14	$395.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.07 / $78.50 / $101.03	Professional	26	$61.07	$78.50	$101.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.03 / $215.31 / $294.87	Professional	TC	$155.03	$215.31	$294.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $192.04 / $293.29 / $664.51	Professional		$192.04	$293.29	$664.51
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $55.20 / $75.34 / $133.86	Professional	26	$55.20	$75.34	$133.86
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $136.83 / $195.24 / $415.08	Professional	TC	$136.83	$195.24	$415.08