Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $758.58	Professional		$323.59	$398.11	$758.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $177.83 / $977.24	Professional	26	$162.18	$177.83	$977.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $213.80 / $707.95	Professional	TC	$177.83	$213.80	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $489.78	Professional		$323.59	$323.59	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $218.78	Professional	26	$154.88	$154.88	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $173.78 / $269.15	Professional	TC	$173.78	$173.78	$269.15
HMSA Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $524.81 / $549.54	Professional		$223.87	$524.81	$549.54
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $295.12 / $295.12	Professional	26	$281.84	$295.12	$295.12
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $251.19 / $251.19	Professional	TC	$239.88	$251.19	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $467.74 / $537.03	Professional		$426.58	$467.74	$537.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $208.93 / $239.88	Professional	26	$190.55	$208.93	$239.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $257.04 / $302.00	Professional	TC	$234.42	$257.04	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $371.54 / $562.34	Professional		$190.55	$371.54	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $112.20 / $288.40	Professional	26	$107.15	$112.20	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $257.04 / $275.42	Professional	TC	$83.18	$257.04	$275.42