Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.90 / $198.99 / $226.54	Professional		$180.90	$198.99	$226.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $22.48 / $77.12	Professional	26	$20.63	$22.48	$77.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $116.51 / $178.34 / $204.06	Professional	TC	$116.51	$178.34	$204.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.34 / $166.29 / $325.94	Professional		$112.34	$166.29	$325.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $27.70 / $51.65	Professional	26	$21.91	$27.70	$51.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.44 / $138.44 / $293.50	Professional	TC	$90.44	$138.44	$293.50
HMSA Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $191.90 / $228.11	Professional		$24.28	$191.90	$228.11
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $26.00 / $27.23 / $27.91	Professional	26	$26.00	$27.23	$27.91
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $165.90 / $173.72 / $203.70	Professional	TC	$165.90	$173.72	$203.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $146.33 / $159.63 / $186.24	Professional		$146.33	$159.63	$186.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.51 / $26.74 / $31.19	Professional	26	$24.51	$26.74	$31.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $121.83 / $132.90 / $155.05	Professional	TC	$121.83	$132.90	$155.05
United Facility/Professional Professional Modifier Low / Median / High Price $116.96 / $166.29 / $218.99	Professional		$116.96	$166.29	$218.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.70 / $27.85 / $38.69	Professional	26	$21.70	$27.85	$38.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.68 / $138.44 / $180.30	Professional	TC	$99.68	$138.44	$180.30
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $165.53 / $343.46	Professional		$123.42	$165.53	$343.46
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $21.15 / $25.17 / $59.23	Professional	26	$21.15	$25.17	$59.23
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $102.27 / $137.16 / $284.23	Professional	TC	$102.27	$137.16	$284.23