Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.71 / $193.88 / $296.56	Professional		$165.71	$193.88	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $61.39 / $90.03	Professional	26	$56.22	$61.39	$90.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.45 / $128.52 / $206.54	Professional	TC	$109.45	$128.52	$206.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.70 / $66.70 / $66.70	Facility	26	$66.70	$66.70	$66.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $215.57 / $298.89 / $843.70	Professional		$215.57	$298.89	$843.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.17 / $69.18 / $129.65	Professional	26	$55.17	$69.18	$129.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $152.38 / $240.52 / $714.05	Professional	TC	$152.38	$240.52	$714.05
HMSA Facility/Professional Professional Modifier Low / Median / High Price $75.20 / $314.42 / $381.66	Professional		$75.20	$314.42	$381.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $77.84 / $81.52 / $83.56	Professional	26	$77.84	$81.52	$83.56
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $252.95 / $264.87 / $316.08	Professional	TC	$252.95	$264.87	$316.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $197.67 / $215.64 / $251.58	Professional		$197.67	$215.64	$251.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.58 / $69.36 / $80.92	Professional	26	$63.58	$69.36	$80.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.09 / $146.28 / $170.66	Professional	TC	$134.09	$146.28	$170.66
United Facility/Professional Professional Modifier Low / Median / High Price $224.63 / $282.30 / $534.04	Professional		$224.63	$282.30	$534.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.18 / $72.25 / $95.15	Professional	26	$56.18	$72.25	$95.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.38 / $224.51 / $438.89	Professional	TC	$152.38	$224.51	$438.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $132.34 / $195.99 / $417.55	Professional		$132.34	$195.99	$417.55
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $43.40 / $66.58 / $144.49	Professional	26	$43.40	$66.58	$144.49
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $88.93 / $132.19 / $261.49	Professional	TC	$88.93	$132.19	$261.49