Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $933.25	Professional		$239.88	$295.12	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $107.15 / $467.74	Professional	26	$79.43	$107.15	$467.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $186.21 / $323.59	Professional	TC	$158.49	$186.21	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $660.69	Professional		$213.80	$309.03	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $107.15 / $181.97	Professional	26	$77.62	$107.15	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $194.98 / $478.63	Professional	TC	$134.90	$194.98	$478.63
HMSA Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $416.87	Professional		$234.42	$398.11	$416.87
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $144.54 / $147.91	Professional	26	$138.04	$144.54	$147.91
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $275.42 / $275.42	Professional	TC	$263.03	$275.42	$275.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $309.03 / $354.81	Professional		$281.84	$309.03	$354.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $100.00 / $117.49	Professional	26	$91.20	$100.00	$117.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $208.93 / $239.88	Professional	TC	$190.55	$208.93	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $398.11	Professional		$218.78	$302.00	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $104.71 / $134.90	Professional	26	$72.44	$104.71	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $181.97 / $263.03	Professional	TC	$147.91	$181.97	$263.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $309.03 / $758.58	Professional		$223.87	$309.03	$758.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $102.33 / $177.83	Professional	26	$74.13	$102.33	$177.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $346.74	Professional	TC	$151.36	$204.17	$346.74