Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.58 / $200.13 / $223.06	Professional		$136.58	$200.13	$223.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.97 / $71.12 / $90.87	Professional	26	$57.97	$71.12	$90.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.95 / $125.43 / $150.93	Professional	TC	$61.95	$125.43	$150.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.87 / $67.87 / $67.87	Facility	26	$67.87	$67.87	$67.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $153.88 / $296.42	Professional		$108.31	$153.88	$296.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.48 / $131.30	Professional	26	$56.23	$72.48	$131.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.08 / $80.59 / $195.58	Professional	TC	$52.08	$80.59	$195.58
HMSA Facility/Professional Professional Modifier Low / Median / High Price $73.16 / $264.20 / $304.61	Professional		$73.16	$264.20	$304.61
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $78.34 / $82.04 / $84.09	Professional	26	$78.34	$82.04	$84.09
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $212.55 / $222.57 / $222.57	Professional	TC	$212.55	$222.57	$222.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.41 / $147.72 / $172.35	Professional		$135.41	$147.72	$172.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.48 / $70.36 / $82.08	Professional	26	$64.48	$70.36	$82.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.93 / $77.38 / $90.27	Professional	TC	$70.93	$77.38	$90.27
United Facility/Professional Professional Modifier Low / Median / High Price $113.29 / $153.88 / $203.31	Professional		$113.29	$153.88	$203.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $59.20 / $73.29 / $97.68	Professional	26	$59.20	$73.29	$97.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.50 / $80.59 / $105.63	Professional	TC	$56.50	$80.59	$105.63
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $109.74 / $149.77 / $328.30	Professional		$109.74	$149.77	$328.30
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $52.73 / $70.70 / $149.80	Professional	26	$52.73	$70.70	$149.80
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $57.02 / $77.81 / $199.58	Professional	TC	$57.02	$77.81	$199.58