Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.54 / $388.43 / $755.46	Professional		$254.54	$388.43	$755.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.79 / $96.73 / $360.72	Professional	26	$71.79	$96.73	$360.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $182.74 / $297.66 / $623.53	Professional	TC	$182.74	$297.66	$623.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $327.70 / $487.68 / $605.23	Professional		$327.70	$487.68	$605.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.98 / $105.58 / $112.38	Professional	26	$85.98	$105.58	$112.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.32 / $376.58 / $499.86	Professional	TC	$215.32	$376.58	$499.86
HMSA Facility/Professional Professional Modifier Low / Median / High Price $106.44 / $485.88 / $619.84	Professional		$106.44	$485.88	$619.84
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $114.00 / $119.37 / $122.35	Professional	26	$114.00	$119.37	$122.35
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $452.25 / $475.10 / $497.49	Professional	TC	$452.25	$475.10	$497.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $532.60 / $581.02 / $677.85	Professional		$532.60	$581.02	$677.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $92.72 / $101.15 / $118.01	Professional	26	$92.72	$101.15	$118.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $439.88 / $479.87 / $559.85	Professional	TC	$439.88	$479.87	$559.85
United Facility/Professional Professional Modifier Low / Median / High Price $415.95 / $522.91 / $699.60	Professional		$415.95	$522.91	$699.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.98 / $105.36 / $139.86	Professional	26	$85.98	$105.36	$139.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $286.54 / $431.88 / $559.74	Professional	TC	$286.54	$431.88	$559.74
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $285.29 / $547.01 / $611.98	Professional		$285.29	$547.01	$611.98
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $63.78 / $102.17 / $112.98	Professional	26	$63.78	$102.17	$112.98
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $186.31 / $444.84 / $499.00	Professional	TC	$186.31	$444.84	$499.00