Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $218.78 / $549.54	Professional		$181.97	$218.78	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $41.69 / $120.23	Professional	26	$23.44	$41.69	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $177.83 / $354.81	Professional	TC	$154.88	$177.83	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $269.15 / $524.81	Professional		$177.83	$269.15	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $37.15 / $85.11	Professional	26	$26.30	$37.15	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $436.52	Professional	TC	$144.54	$218.78	$436.52
HMSA Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $288.40	Professional		$177.83	$257.04	$288.40
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $40.74 / $41.69	Professional	26	$38.90	$40.74	$41.69
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $208.93 / $245.47	Professional	TC	$199.53	$208.93	$245.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $263.03 / $309.03	Professional		$245.47	$263.03	$309.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $44.67 / $52.48	Professional	26	$40.74	$44.67	$52.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $218.78 / $257.04	Professional	TC	$204.17	$218.78	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $269.15 / $323.59	Professional		$190.55	$269.15	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $37.15 / $60.26	Professional	26	$29.51	$37.15	$60.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $218.78 / $295.12	Professional	TC	$154.88	$218.78	$295.12
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $407.38	Professional		$194.98	$257.04	$407.38
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $39.81 / $95.50	Professional	26	$26.30	$39.81	$95.50
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $309.03	Professional	TC	$158.49	$213.80	$309.03