Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.64 / $234.46 / $467.91	Professional		$206.64	$234.46	$467.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.42 / $53.24 / $69.54	Professional	26	$44.42	$53.24	$69.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.96 / $183.52 / $398.36	Professional	TC	$169.96	$183.52	$398.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.68 / $346.65 / $711.33	Professional		$247.68	$346.65	$711.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.13 / $55.88 / $101.17	Professional	26	$43.13	$55.88	$101.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.55 / $293.83 / $626.92	Professional	TC	$204.55	$293.83	$626.92
HMSA Facility/Professional Professional Modifier Low / Median / High Price $58.43 / $311.07 / $390.51	Professional		$58.43	$311.07	$390.51
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $62.00 / $64.92 / $66.54	Professional	26	$62.00	$64.92	$66.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $288.25 / $326.95 / $342.37	Professional	TC	$288.25	$326.95	$342.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $307.75 / $335.72 / $391.68	Professional		$307.75	$335.72	$391.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.17 / $53.64 / $62.58	Professional	26	$49.17	$53.64	$62.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $258.57 / $282.07 / $329.08	Professional	TC	$258.57	$282.07	$329.08
United Facility/Professional Professional Modifier Low / Median / High Price $251.79 / $349.71 / $467.90	Professional		$251.79	$349.71	$467.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.91 / $55.88 / $75.18	Professional	26	$43.91	$55.88	$75.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.55 / $293.83 / $392.72	Professional	TC	$211.55	$293.83	$392.72
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $243.51 / $324.87 / $426.26	Professional		$243.51	$324.87	$426.26
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $41.14 / $54.57 / $113.57	Professional	26	$41.14	$54.57	$113.57
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $189.48 / $257.54 / $329.78	Professional	TC	$189.48	$257.54	$329.78