Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $69.18 / $81.28	Facility	26	$60.26	$69.18	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $245.47 / $660.69	Professional		$169.82	$245.47	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $83.18 / $338.84	Professional	26	$54.95	$83.18	$338.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $158.49 / $323.59	Professional	TC	$102.33	$158.49	$323.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $263.03 / $489.78	Professional		$229.09	$263.03	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $134.90	Professional	26	$51.29	$75.86	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $204.17 / $354.81	Professional	TC	$151.36	$204.17	$354.81
HMSA Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $323.59 / $346.74	Professional		$213.80	$323.59	$346.74
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $239.88 / $251.19	Professional	TC	$239.88	$239.88	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $257.04	Professional		$177.83	$208.93	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $91.20	Professional	26	$61.66	$72.44	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $134.90 / $169.82	Professional	TC	$114.82	$134.90	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $346.74 / $407.38	Professional		$190.55	$346.74	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $131.83	Professional	26	$70.79	$81.28	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $234.42 / $323.59	Professional	TC	$120.23	$234.42	$323.59
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $512.86	Professional		$223.87	$323.59	$512.86
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $134.90	Professional	26	$69.18	$91.20	$134.90
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $263.03 / $398.11	Professional	TC	$144.54	$263.03	$398.11