Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.63 / $67.58 / $79.50	Facility	26	$59.63	$67.58	$79.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $368.37 / $444.84	Professional		$171.00	$368.37	$444.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $62.17 / $90.99	Professional	26	$51.30	$62.17	$90.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $306.18 / $375.83	Professional	TC	$119.70	$306.18	$375.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $307.86 / $363.05 / $476.82	Professional		$307.86	$363.05	$476.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.58 / $80.56 / $89.76	Professional	26	$67.58	$80.56	$89.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.59 / $282.50 / $395.85	Professional	TC	$223.59	$282.50	$395.85
HMSA Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $449.13 / $514.46	Professional		$82.06	$449.13	$514.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $89.95 / $94.19 / $96.54	Professional	26	$89.95	$94.19	$96.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $359.18 / $376.10 / $376.10	Professional	TC	$359.18	$376.10	$376.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $252.84 / $275.82 / $321.79	Professional		$252.84	$275.82	$321.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.78 / $70.67 / $82.45	Professional	26	$64.78	$70.67	$82.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $188.06 / $205.15 / $217.12	Professional	TC	$188.06	$205.15	$217.12
United Facility/Professional Professional Modifier Low / Median / High Price $141.13 / $310.30 / $443.66	Professional		$141.13	$310.30	$443.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.11 / $79.50 / $203.30	Professional	26	$38.11	$79.50	$203.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.03 / $230.80 / $373.88	Professional	TC	$103.03	$230.80	$373.88
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $284.80 / $473.38 / $807.73	Professional		$284.80	$473.38	$807.73
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $68.29 / $97.76 / $163.59	Professional	26	$68.29	$97.76	$163.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $211.99 / $396.17 / $653.44	Professional	TC	$211.99	$396.17	$653.44