Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.43 / $324.82 / $948.00	Professional		$286.43	$324.82	$948.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.96 / $41.42 / $53.98	Professional	26	$37.96	$41.42	$53.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.47 / $260.68 / $392.28	Professional	TC	$248.47	$260.68	$392.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.98 / $42.98 / $42.98	Facility	26	$42.98	$42.98	$42.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $222.50 / $329.38 / $668.52	Professional		$222.50	$329.38	$668.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $44.59 / $79.20	Professional	26	$34.47	$44.59	$79.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $188.03 / $282.19 / $589.30	Professional	TC	$188.03	$282.19	$589.30
HMSA Facility/Professional Professional Modifier Low / Median / High Price $44.57 / $358.94 / $383.84	Professional		$44.57	$358.94	$383.84
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $47.73 / $48.92 / $51.23	Professional	26	$47.73	$48.92	$51.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $317.64 / $317.64 / $332.62	Professional	TC	$317.64	$317.64	$332.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $293.92 / $320.64 / $374.08	Professional		$293.92	$320.64	$374.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.24 / $42.80 / $49.94	Professional	26	$39.24	$42.80	$49.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $254.68 / $277.83 / $324.14	Professional	TC	$254.68	$277.83	$324.14
United Facility/Professional Professional Modifier Low / Median / High Price $240.87 / $334.00 / $457.12	Professional		$240.87	$334.00	$457.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.38 / $54.28 / $59.72	Professional	26	$36.38	$54.28	$59.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $208.38 / $289.41 / $397.40	Professional	TC	$208.38	$289.41	$397.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $204.77 / $297.33 / $362.74	Professional		$204.77	$297.33	$362.74
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $27.19 / $39.47 / $48.16	Professional	26	$27.19	$39.47	$48.16
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $177.58 / $257.85 / $314.58	Professional	TC	$177.58	$257.85	$314.58