Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $79.43 / $93.33	Facility	26	$69.18	$79.43	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $1,288.25	Professional		$295.12	$426.58	$1,288.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $112.20 / $512.86	Professional	26	$72.44	$112.20	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $295.12 / $562.34	Professional	TC	$218.78	$295.12	$562.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $467.74 / $676.08	Professional		$346.74	$467.74	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $154.88	Professional	26	$58.88	$85.11	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $398.11 / $562.34	Professional	TC	$288.40	$398.11	$562.34
HMSA Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $741.31 / $812.83	Professional		$537.03	$741.31	$812.83
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $95.50 / $100.00	Professional	26	$93.33	$95.50	$100.00
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $575.44 / $575.44 / $602.56	Professional	TC	$575.44	$575.44	$602.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $346.74 / $398.11	Professional		$295.12	$346.74	$398.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $95.50	Professional	26	$70.79	$81.28	$95.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $309.03	Professional	TC	$223.87	$263.03	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $691.83	Professional		$316.23	$478.63	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $93.33 / $151.36	Professional	26	$81.28	$93.33	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $371.54 / $588.84	Professional	TC	$234.42	$371.54	$588.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $512.86 / $831.76	Professional		$354.81	$512.86	$831.76
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $102.33 / $177.83	Professional	26	$69.18	$102.33	$177.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $426.58 / $691.83	Professional	TC	$269.15	$426.58	$691.83