Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $512.86	Professional		$120.23	$173.78	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $24.55 / $112.20	Professional	26	$19.95	$24.55	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $147.91 / $263.03	Professional	TC	$104.71	$147.91	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $346.74	Professional		$117.49	$181.97	$346.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $25.12 / $46.77	Professional	26	$19.95	$25.12	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $302.00	Professional	TC	$97.72	$154.88	$302.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $229.09 / $269.15	Professional		$36.31	$229.09	$269.15
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $30.90 / $31.62	Professional	26	$29.51	$30.90	$31.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $199.53 / $199.53	Professional	TC	$190.55	$199.53	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $208.93	Professional		$162.18	$177.83	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.12 / $29.51	Professional	26	$23.44	$25.12	$29.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $151.36 / $177.83	Professional	TC	$141.25	$151.36	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $177.83 / $245.47	Professional		$125.89	$177.83	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.12 / $33.88	Professional	26	$18.20	$25.12	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $151.36 / $218.78	Professional	TC	$104.71	$151.36	$218.78
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $363.08	Professional		$125.89	$173.78	$363.08
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.70 / $52.48	Professional	26	$19.05	$25.70	$52.48
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $144.54 / $309.03	Professional	TC	$107.15	$144.54	$309.03