Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $269.15	Professional		$102.33	$144.54	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $32.36 / $64.57	Professional	26	$23.99	$32.36	$64.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $114.82 / $204.17	Professional	TC	$69.18	$114.82	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $407.38	Professional		$144.54	$199.53	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $54.95	Professional	26	$22.91	$36.31	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $169.82 / $354.81	Professional	TC	$120.23	$169.82	$354.81
HMSA Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $194.98 / $223.87	Professional		$151.36	$194.98	$223.87
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $42.66	Professional	26	$39.81	$41.69	$42.66
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $158.49 / $190.55	Professional	TC	$151.36	$158.49	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $223.87	Professional		$173.78	$190.55	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $44.67 / $51.29	Professional	26	$40.74	$44.67	$51.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $144.54 / $169.82	Professional	TC	$131.83	$144.54	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $208.93 / $269.15	Professional		$141.25	$208.93	$269.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $35.48 / $41.69	Professional	26	$23.44	$35.48	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $169.82 / $229.09	Professional	TC	$109.65	$169.82	$229.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $371.54	Professional		$120.23	$173.78	$371.54
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $35.48 / $61.66	Professional	26	$22.39	$35.48	$61.66
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $144.54 / $316.23	Professional	TC	$89.13	$144.54	$316.23