Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.84 / $140.41 / $222.42	Professional		$119.84	$140.41	$222.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $17.45 / $33.82	Professional	26	$15.93	$17.45	$33.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.95 / $112.49 / $187.00	Professional	TC	$106.95	$112.49	$187.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.70 / $26.70 / $26.70	Facility	26	$26.70	$26.70	$26.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.56 / $165.60 / $324.39	Professional		$111.56	$165.60	$324.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $26.98 / $51.96	Professional	26	$17.57	$26.98	$51.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.84 / $137.96 / $280.70	Professional	TC	$89.84	$137.96	$280.70
HMSA Facility/Professional Professional Modifier Low / Median / High Price $22.49 / $166.28 / $195.53	Professional		$22.49	$166.28	$195.53
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $25.21 / $25.85	Professional	26	$24.08	$25.21	$25.85
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $142.19 / $148.90 / $174.16	Professional	TC	$142.19	$148.90	$174.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $145.72 / $158.97 / $185.47	Professional		$145.72	$158.97	$185.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.31 / $26.52 / $30.94	Professional	26	$24.31	$26.52	$30.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $121.41 / $132.44 / $154.52	Professional	TC	$121.41	$132.44	$154.52
United Facility/Professional Professional Modifier Low / Median / High Price $116.82 / $165.60 / $219.80	Professional		$116.82	$165.60	$219.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.70 / $27.63 / $38.27	Professional	26	$19.70	$27.63	$38.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.33 / $137.96 / $181.53	Professional	TC	$99.33	$137.96	$181.53
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $122.83 / $147.71 / $343.39	Professional		$122.83	$147.71	$343.39
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $23.80 / $58.21	Professional	26	$17.30	$23.80	$58.21
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $101.93 / $126.55 / $285.18	Professional	TC	$101.93	$126.55	$285.18