Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $575.44	Professional		$380.19	$436.52	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $316.23	Professional	26	$52.48	$64.57	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $380.19 / $489.78	Professional	TC	$323.59	$380.19	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $724.44 / $933.25	Professional		$549.54	$724.44	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $83.18 / $117.49	Professional	26	$67.61	$83.18	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $630.96 / $831.76	Professional	TC	$478.63	$630.96	$831.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,023.29 / $1,174.90	Professional		$758.58	$1,023.29	$1,174.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $125.89 / $131.83	Professional	26	$117.49	$125.89	$131.83
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $851.14 / $891.25 / $891.25	Professional	TC	$851.14	$891.25	$891.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $645.65 / $812.83	Professional		$588.84	$645.65	$812.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $89.13	Professional	26	$66.07	$70.79	$89.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $524.81 / $575.44 / $724.44	Professional	TC	$524.81	$575.44	$724.44
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $524.81 / $707.95	Professional		$416.87	$524.81	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $114.82	Professional	26	$53.70	$69.18	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $457.09 / $588.84	Professional	TC	$363.08	$457.09	$588.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $588.84 / $794.33	Professional		$407.38	$588.84	$794.33
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $87.10	Professional	26	$51.29	$74.13	$87.10
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $524.81 / $691.83	Professional	TC	$354.81	$524.81	$691.83