Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.64 / $224.58 / $362.27	Professional		$177.64	$224.58	$362.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $37.53 / $108.52	Professional	26	$7.33	$37.53	$108.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.96 / $178.73 / $282.39	Professional	TC	$169.96	$178.73	$282.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $171.60 / $254.14 / $507.64	Professional		$171.60	$254.14	$507.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $45.28 / $84.12	Professional	26	$33.79	$45.28	$84.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $136.25 / $208.35 / $423.52	Professional	TC	$136.25	$208.35	$423.52
HMSA Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $251.70 / $293.50	Professional		$36.95	$251.70	$293.50
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $38.25 / $40.04 / $41.06	Professional	26	$38.25	$40.04	$41.06
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $213.45 / $223.51 / $262.72	Professional	TC	$213.45	$223.51	$262.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.64 / $243.97 / $284.63	Professional		$223.64	$243.97	$284.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $43.96 / $51.28	Professional	26	$40.29	$43.96	$51.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $183.35 / $200.02 / $233.35	Professional	TC	$183.35	$200.02	$233.35
United Facility/Professional Professional Modifier Low / Median / High Price $182.98 / $284.39 / $341.15	Professional		$182.98	$284.39	$341.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $45.79 / $62.39	Professional	26	$32.97	$45.79	$62.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $150.01 / $208.35 / $278.76	Professional	TC	$150.01	$208.35	$278.76
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $193.32 / $259.27 / $422.78	Professional		$193.32	$259.27	$422.78
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $45.84 / $95.47	Professional	26	$33.72	$45.84	$95.47
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $157.96 / $211.86 / $347.16	Professional	TC	$157.96	$211.86	$347.16