Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.39 / $370.79 / $713.20	Professional		$194.39	$370.79	$713.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.00 / $57.54 / $200.00	Professional	26	$45.00	$57.54	$200.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $149.38 / $262.75 / $576.02	Professional	TC	$149.38	$262.75	$576.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.18 / $402.82 / $531.42	Professional		$234.18	$402.82	$531.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $69.81 / $71.42	Professional	26	$56.84	$69.81	$71.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.76 / $332.32 / $461.76	Professional	TC	$162.76	$332.32	$461.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $404.66 / $474.91	Professional		$67.47	$404.66	$474.91
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $72.25 / $75.65 / $77.55	Professional	26	$72.25	$75.65	$77.55
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $379.48 / $397.36 / $397.36	Professional	TC	$379.48	$397.36	$397.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $467.65 / $510.17 / $595.20	Professional		$467.65	$510.17	$595.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.30 / $66.88 / $78.02	Professional	26	$61.30	$66.88	$78.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $406.35 / $443.29 / $517.16	Professional	TC	$406.35	$443.29	$517.16
United Facility/Professional Professional Modifier Low / Median / High Price $371.40 / $464.65 / $627.65	Professional		$371.40	$464.65	$627.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $68.48 / $92.15	Professional	26	$56.84	$68.48	$92.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $312.79 / $398.96 / $535.50	Professional	TC	$312.79	$398.96	$535.50
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $181.98 / $477.01 / $713.52	Professional		$181.98	$477.01	$713.52
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $43.00 / $64.31 / $76.17	Professional	26	$43.00	$64.31	$76.17
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $118.99 / $371.14 / $442.68	Professional	TC	$118.99	$371.14	$442.68