Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $603.55 / $761.38 / $1,138.79	Professional		$603.55	$761.38	$1,138.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.21 / $156.04 / $524.60	Professional	26	$118.21	$156.04	$524.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $301.77 / $301.77 / $416.28	Professional	52	$301.77	$301.77	$416.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $464.72 / $624.35 / $960.19	Professional	TC	$464.72	$624.35	$960.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $696.13 / $853.10 / $1,029.95	Professional		$696.13	$853.10	$1,029.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.71 / $161.49 / $216.25	Professional	26	$117.71	$161.49	$216.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $578.42 / $708.86 / $813.70	Professional	TC	$578.42	$708.86	$813.70
HMSA Facility/Professional Professional Modifier Low / Median / High Price $222.38 / $1,006.90 / $1,186.17	Professional		$222.38	$1,006.90	$1,186.17
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $219.60 / $249.85 / $261.62	Professional	26	$219.60	$249.85	$261.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $882.95 / $924.55 / $924.55	Professional	TC	$882.95	$924.55	$924.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $750.73 / $818.98 / $955.47	Professional		$750.73	$818.98	$955.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $126.94 / $138.47 / $161.56	Professional	26	$126.94	$138.47	$161.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $623.79 / $680.51 / $793.93	Professional	TC	$623.79	$680.51	$793.93
United Facility/Professional Professional Modifier Low / Median / High Price $619.70 / $776.38 / $1,041.72	Professional		$619.70	$776.38	$1,041.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $117.71 / $144.25 / $192.54	Professional	26	$117.71	$144.25	$192.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $496.23 / $624.38 / $849.18	Professional	TC	$496.23	$624.38	$849.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $591.65 / $863.11 / $1,557.13	Professional		$591.65	$863.11	$1,557.13
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $87.28 / $144.63 / $173.33	Professional	26	$87.28	$144.63	$173.33
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $399.96 / $697.90 / $833.62	Professional	TC	$399.96	$697.90	$833.62