Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $371.54	Professional		$229.09	$295.12	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $128.82	Professional	26	$81.28	$100.00	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $263.03	Professional	TC	$141.25	$190.55	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $467.74	Professional		$218.78	$354.81	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $128.82 / $151.36	Professional	26	$117.49	$128.82	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $234.42 / $331.13	Professional	TC	$87.10	$234.42	$331.13
HMSA Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $467.74 / $524.81	Professional		$162.18	$467.74	$524.81
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $138.04 / $141.25	Professional	26	$131.83	$138.04	$141.25
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $363.08 / $380.19	Professional	TC	$331.13	$363.08	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $407.38 / $512.86	Professional		$380.19	$407.38	$512.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $125.89 / $158.49	Professional	26	$114.82	$125.89	$158.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $281.84 / $354.81	Professional	TC	$263.03	$281.84	$354.81
United Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $389.05	Professional		$275.42	$338.84	$389.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $123.03 / $131.83	Professional	26	$95.50	$123.03	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $223.87 / $263.03	Professional	TC	$165.96	$223.87	$263.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $489.78	Professional		$194.98	$338.84	$489.78
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $117.49 / $131.83	Professional	26	$75.86	$117.49	$131.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $213.80 / $380.19	Professional	TC	$77.62	$213.80	$380.19