Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.36 / $60.47 / $71.15	Facility	26	$53.36	$60.47	$71.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.72 / $265.33 / $285.94	Professional		$232.72	$265.33	$285.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $54.00 / $146.51	Professional	26	$48.57	$54.00	$146.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $183.84 / $184.15 / $229.28	Professional	TC	$183.84	$184.15	$229.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.34 / $61.34 / $61.34	Facility	26	$61.34	$61.34	$61.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $184.99 / $258.67 / $342.00	Professional		$184.99	$258.67	$342.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.06 / $62.71 / $77.36	Professional	26	$58.06	$62.71	$77.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $124.53 / $206.44 / $264.64	Professional	TC	$124.53	$206.44	$264.64
HMSA Facility/Professional Professional Modifier Low / Median / High Price $64.42 / $357.89 / $411.48	Professional		$64.42	$357.89	$411.48
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $70.61 / $73.94 / $75.79	Professional	26	$70.61	$73.94	$75.79
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $287.27 / $300.82 / $300.82	Professional	TC	$287.27	$300.82	$300.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.33 / $193.45 / $225.69	Professional		$177.33	$193.45	$225.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.97 / $63.24 / $73.78	Professional	26	$57.97	$63.24	$73.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $119.37 / $130.22 / $137.82	Professional	TC	$119.37	$130.22	$137.82
United Facility/Professional Professional Modifier Low / Median / High Price $93.51 / $217.63 / $274.19	Professional		$93.51	$217.63	$274.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $71.15 / $89.30	Professional	26	$34.04	$71.15	$89.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.47 / $146.50 / $184.89	Professional	TC	$59.47	$146.50	$184.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $199.73 / $294.92 / $588.76	Professional		$199.73	$294.92	$588.76
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $53.27 / $80.30 / $137.06	Professional	26	$53.27	$80.30	$137.06
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $134.56 / $233.43 / $473.96	Professional	TC	$134.56	$233.43	$473.96