Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $60.26 / $70.79	Facility	26	$53.70	$60.26	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $275.42 / $933.25	Professional		$158.49	$275.42	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $83.18 / $251.19	Professional	26	$52.48	$83.18	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $154.88 / $338.84	Professional	TC	$102.33	$154.88	$338.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $295.12 / $407.38	Professional		$190.55	$295.12	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $117.49	Professional	26	$51.29	$72.44	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $223.87 / $309.03	Professional	TC	$128.82	$223.87	$309.03
HMSA Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $389.05 / $416.87	Professional		$295.12	$389.05	$416.87
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $87.10	Professional	26	$81.28	$83.18	$87.10
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $288.40 / $302.00	Professional	TC	$288.40	$288.40	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $251.19	Professional		$169.82	$199.53	$251.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $63.10 / $79.43	Professional	26	$54.95	$63.10	$79.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $134.90 / $169.82	Professional	TC	$117.49	$134.90	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $426.58	Professional		$181.97	$251.19	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $114.82	Professional	26	$61.66	$81.28	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $165.96 / $346.74	Professional	TC	$120.23	$165.96	$346.74
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $331.13 / $645.65	Professional		$213.80	$331.13	$645.65
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $81.28 / $131.83	Professional	26	$64.57	$81.28	$131.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $257.04 / $524.81	Professional	TC	$147.91	$257.04	$524.81