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 $326.48 / $332.37 / $409.21	Professional		$326.48	$332.37	$409.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.50 / $73.93 / $81.50	Professional	26	$59.50	$73.93	$81.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $244.98 / $272.87 / $339.73	Professional	TC	$244.98	$272.87	$339.73
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 $264.57 / $302.74 / $403.41	Professional		$264.57	$302.74	$403.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.47 / $76.48 / $84.97	Professional	26	$60.47	$76.48	$84.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.49 / $226.26 / $328.00	Professional	TC	$193.49	$226.26	$328.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $78.39 / $384.77 / $428.04	Professional		$78.39	$384.77	$428.04
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $85.92 / $89.97 / $92.22	Professional	26	$85.92	$89.97	$92.22
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $298.85 / $312.93 / $312.93	Professional	TC	$298.85	$312.93	$312.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $216.99 / $236.71 / $276.16	Professional		$216.99	$236.71	$276.16
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 $159.03 / $173.48 / $183.60	Professional	TC	$159.03	$173.48	$183.60
United Facility/Professional Professional Modifier Low / Median / High Price $127.30 / $266.30 / $406.58	Professional		$127.30	$266.30	$406.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $71.15 / $103.53	Professional	26	$34.04	$71.15	$103.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.26 / $203.11 / $303.05	Professional	TC	$93.26	$203.11	$303.05
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $244.43 / $421.21 / $719.60	Professional		$244.43	$421.21	$719.60
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $65.16 / $87.51 / $146.41	Professional	26	$65.16	$87.51	$146.41
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $179.27 / $323.60 / $575.91	Professional	TC	$179.27	$323.60	$575.91