Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.93 / $118.92 / $145.74	Facility	26	$104.93	$118.92	$145.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $287.18 / $364.10 / $755.37	Professional	TC	$287.18	$364.10	$755.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $487.06 / $498.51 / $605.54	Professional	TC	$487.06	$498.51	$605.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $556.74 / $556.74 / $556.74	Professional	TC	$556.74	$556.74	$556.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $128.25 / $139.91 / $163.22	Professional	26	$128.25	$139.91	$163.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $532.88 / $581.33 / $678.22	Professional	TC	$532.88	$581.33	$678.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $412.72 / $543.30 / $706.50	Professional	TC	$412.72	$543.30	$706.50
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $354.40 / $457.38 / $587.28	Professional	TC	$354.40	$457.38	$587.28