Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $690.59 / $1,532.74 / $2,808.15	Facility		$690.59	$1,532.74	$2,808.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.91 / $240.98 / $947.10	Professional		$51.91	$240.98	$947.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.87 / $74.36 / $274.00	Professional	26	$63.87	$74.36	$274.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.89 / $183.15 / $665.00	Professional	TC	$168.89	$183.15	$665.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.59 / $219.59 / $219.59	Facility		$219.59	$219.59	$219.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $78.01 / $78.01	Facility	26	$78.01	$78.01	$78.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $179.79 / $261.23 / $560.24	Professional		$179.79	$261.23	$560.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.72 / $84.10 / $135.80	Professional	26	$64.72	$84.10	$135.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.07 / $187.60 / $424.44	Professional	TC	$115.07	$187.60	$424.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $113.61 / $360.19 / $2,342.00	Professional		$113.61	$360.19	$2,342.00
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $117.61 / $123.15 / $126.23	Professional	26	$117.61	$123.15	$126.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $242.58 / $254.01 / $254.01	Professional	TC	$242.58	$254.01	$254.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $228.33 / $249.08 / $290.60	Professional		$228.33	$249.08	$290.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.01 / $80.73 / $94.19	Professional	26	$74.01	$80.73	$94.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.32 / $168.35 / $196.41	Professional	TC	$154.32	$168.35	$196.41
United Facility/Professional Professional Modifier Low / Median / High Price $15.00 / $259.45 / $349.82	Professional		$15.00	$259.45	$349.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.16 / $84.10 / $116.25	Professional	26	$56.16	$84.10	$116.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.28 / $175.36 / $233.57	Professional	TC	$142.28	$175.36	$233.57
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $196.91 / $271.66 / $633.94	Professional		$196.91	$271.66	$633.94
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $55.53 / $88.35 / $154.04	Professional	26	$55.53	$88.35	$154.04
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $132.35 / $193.07 / $317.72	Professional	TC	$132.35	$193.07	$317.72