Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $286.41 / $1,234.25 / $1,234.25	Facility		$286.41	$1,234.25	$1,234.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $280.67 / $359.38	Professional		$54.79	$280.67	$359.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.65 / $37.77 / $115.41	Professional	26	$29.65	$37.77	$115.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.77 / $183.28 / $375.25	Professional	TC	$169.77	$183.28	$375.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $268.80 / $268.80 / $268.80	Facility		$268.80	$268.80	$268.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.91 / $42.91 / $42.91	Facility	26	$42.91	$42.91	$42.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $227.42 / $227.42 / $227.42	Facility	TC	$227.42	$227.42	$227.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $216.52 / $321.73 / $659.04	Professional		$216.52	$321.73	$659.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.96 / $44.37 / $82.90	Professional	26	$32.96	$44.37	$82.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.47 / $276.86 / $576.14	Professional	TC	$181.47	$276.86	$576.14
HMSA Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $285.13 / $338.46	Professional		$36.39	$285.13	$338.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $38.97 / $40.82 / $41.83	Professional	26	$38.97	$40.82	$41.83
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $246.15 / $257.75 / $301.83	Professional	TC	$246.15	$257.75	$301.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $283.12 / $308.86 / $360.33	Professional		$283.12	$308.86	$360.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $43.07 / $50.25	Professional	26	$39.47	$43.07	$50.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $243.64 / $265.79 / $310.08	Professional	TC	$243.64	$265.79	$310.08
United Facility/Professional Professional Modifier Low / Median / High Price $193.59 / $321.73 / $435.63	Professional		$193.59	$321.73	$435.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $44.86 / $61.14	Professional	26	$32.29	$44.86	$61.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.62 / $276.86 / $374.49	Professional	TC	$163.62	$276.86	$374.49
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $232.80 / $288.64 / $692.90	Professional		$232.80	$288.64	$692.90
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.52 / $39.79 / $94.53	Professional	26	$32.52	$39.79	$94.53
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $199.81 / $248.85 / $598.37	Professional	TC	$199.81	$248.85	$598.37