Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.04 / $334.37 / $714.81	Professional		$205.04	$334.37	$714.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $160.04 / $277.10 / $627.58	Professional	TC	$160.04	$277.10	$627.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.70 / $420.47 / $572.78	Professional		$278.70	$420.47	$572.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $207.29 / $350.41 / $503.11	Professional	TC	$207.29	$350.41	$503.11
HMSA Facility/Professional Professional Modifier Low / Median / High Price $67.47 / $446.93 / $572.71	Professional		$67.47	$446.93	$572.71
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $450.15 / $472.88 / $495.16	Professional	TC	$450.15	$472.88	$495.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $504.04 / $549.86 / $641.51	Professional		$504.04	$549.86	$641.51
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 $442.74 / $482.99 / $563.49	Professional	TC	$442.74	$482.99	$563.49
United Facility/Professional Professional Modifier Low / Median / High Price $354.10 / $500.29 / $676.02	Professional		$354.10	$500.29	$676.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $340.76 / $434.69 / $583.26	Professional	TC	$340.76	$434.69	$583.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $235.22 / $451.29 / $558.84	Professional		$235.22	$451.29	$558.84
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $172.67 / $387.26 / $482.16	Professional	TC	$172.67	$387.26	$482.16