Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.60 / $279.60 / $289.94	Professional		$179.60	$279.60	$289.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.15 / $28.31 / $34.65	Professional	26	$23.15	$28.31	$34.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $156.46 / $251.29 / $255.28	Professional	TC	$156.46	$251.29	$255.28
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 $143.84 / $216.69 / $439.62	Professional		$143.84	$216.69	$439.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $28.33 / $51.96	Professional	26	$21.91	$28.33	$51.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.93 / $188.38 / $387.67	Professional	TC	$121.93	$188.38	$387.67
HMSA Facility/Professional Professional Modifier Low / Median / High Price $30.12 / $263.89 / $318.52	Professional		$30.12	$263.89	$318.52
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $32.25 / $33.77 / $34.61	Professional	26	$32.25	$33.77	$34.61
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $231.65 / $242.57 / $242.57	Professional	TC	$231.65	$242.57	$242.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.69 / $208.02 / $242.69	Professional		$190.69	$208.02	$242.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.93 / $27.19 / $31.72	Professional	26	$24.93	$27.19	$31.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $165.77 / $180.84 / $210.98	Professional	TC	$165.77	$180.84	$210.98
United Facility/Professional Professional Modifier Low / Median / High Price $156.02 / $243.80 / $280.49	Professional		$156.02	$243.80	$280.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.11 / $28.33 / $38.27	Professional	26	$23.11	$28.33	$38.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.63 / $188.38 / $242.22	Professional	TC	$135.63	$188.38	$242.22
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $155.90 / $209.09 / $450.18	Professional		$155.90	$209.09	$450.18
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $21.28 / $28.55 / $58.21	Professional	26	$21.28	$28.55	$58.21
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $134.61 / $180.53 / $391.94	Professional	TC	$134.61	$180.53	$391.94