Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.71 / $68.80 / $80.95	Facility	26	$60.71	$68.80	$80.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.78 / $243.96 / $285.52	Professional		$232.78	$243.96	$285.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.15 / $84.08 / $169.83	Professional	26	$55.15	$84.08	$169.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $168.34 / $190.14 / $221.14	Professional	TC	$168.34	$190.14	$221.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.79 / $69.79 / $69.79	Facility	26	$69.79	$69.79	$69.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $259.83 / $344.93	Professional		$231.19	$259.83	$344.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $71.16 / $88.37	Professional	26	$65.61	$71.16	$88.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $150.27 / $188.68 / $277.02	Professional	TC	$150.27	$188.68	$277.02
HMSA Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $319.88 / $343.55	Professional		$73.00	$319.88	$343.55
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $80.02 / $83.79 / $85.88	Professional	26	$80.02	$83.79	$85.88
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $239.86 / $251.16 / $251.16	Professional	TC	$239.86	$251.16	$251.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $189.41 / $206.63 / $241.07	Professional		$189.41	$206.63	$241.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.95 / $71.95 / $83.94	Professional	26	$65.95	$71.95	$83.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $123.45 / $134.68 / $142.53	Professional	TC	$123.45	$134.68	$142.53
United Facility/Professional Professional Modifier Low / Median / High Price $114.69 / $232.46 / $343.86	Professional		$114.69	$232.46	$343.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.52 / $96.21 / $100.91	Professional	26	$38.52	$96.21	$100.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.17 / $151.51 / $247.65	Professional	TC	$76.17	$151.51	$247.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $213.32 / $361.20 / $515.48	Professional		$213.32	$361.20	$515.48
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $60.76 / $90.67 / $154.24	Professional	26	$60.76	$90.67	$154.24
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $139.16 / $270.56 / $394.70	Professional	TC	$139.16	$270.56	$394.70