Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $45.71 / $56.23	Facility	26	$39.81	$45.71	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $489.78	Professional		$257.04	$338.84	$489.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $295.12 / $426.58	Professional	TC	$223.87	$295.12	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $416.87 / $616.60	Professional		$407.38	$416.87	$616.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $371.54 / $537.03	Professional	TC	$354.81	$371.54	$537.03
HMSA Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $467.74 / $2,344.23	Professional		$66.07	$467.74	$2,344.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $416.87 / $416.87	Professional	TC	$398.11	$416.87	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $537.03 / $676.08	Professional		$489.78	$537.03	$676.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $56.23 / $70.79	Professional	26	$51.29	$56.23	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $478.63 / $602.56	Professional	TC	$446.68	$478.63	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $512.86	Professional		$363.08	$436.52	$512.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $389.05 / $457.09	Professional	TC	$323.59	$389.05	$457.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $380.19 / $489.78	Professional		$295.12	$380.19	$489.78
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $331.13 / $436.52	Professional	TC	$263.03	$331.13	$436.52