Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $168.09 / $249.16 / $990.77	Professional		$168.09	$249.16	$990.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.89 / $62.59 / $177.60	Professional	26	$37.89	$62.59	$177.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.06 / $178.34 / $206.11	Professional	TC	$130.06	$178.34	$206.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.91 / $204.68 / $406.52	Professional		$143.91	$204.68	$406.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.59 / $46.26 / $97.73	Professional	26	$35.59	$46.26	$97.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.33 / $152.13 / $321.17	Professional	TC	$108.33	$152.13	$321.17
HMSA Facility/Professional Professional Modifier Low / Median / High Price $73.17 / $216.90 / $270.77	Professional		$73.17	$216.90	$270.77
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $75.75 / $79.31 / $81.30	Professional	26	$75.75	$79.31	$81.30
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $167.95 / $175.86 / $202.24	Professional	TC	$167.95	$175.86	$202.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $174.59 / $190.46 / $222.21	Professional		$174.59	$190.46	$222.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.71 / $44.41 / $51.81	Professional	26	$40.71	$44.41	$51.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $133.88 / $146.05 / $170.39	Professional	TC	$133.88	$146.05	$170.39
United Facility/Professional Professional Modifier Low / Median / High Price $149.30 / $207.57 / $279.49	Professional		$149.30	$207.57	$279.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.75 / $48.84 / $62.66	Professional	26	$37.75	$48.84	$62.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.01 / $152.13 / $216.83	Professional	TC	$111.01	$152.13	$216.83
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $141.96 / $207.09 / $408.11	Professional		$141.96	$207.09	$408.11
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $50.22 / $95.43	Professional	26	$33.97	$50.22	$95.43
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $107.98 / $151.44 / $312.69	Professional	TC	$107.98	$151.44	$312.69