Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $74.13 / $87.10	Facility	26	$64.57	$74.13	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $288.40 / $1,202.26	Professional		$194.98	$288.40	$1,202.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $354.81	Professional	26	$61.66	$91.20	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $190.55 / $426.58	Professional	TC	$125.89	$190.55	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $426.58	Professional		$245.47	$295.12	$426.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $144.54	Professional	26	$54.95	$81.28	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $223.87 / $331.13	Professional	TC	$181.97	$223.87	$331.13
HMSA Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $380.19 / $407.38	Professional		$107.15	$380.19	$407.38
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $91.20	Professional	26	$85.11	$87.10	$91.20
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 $208.93 / $239.88 / $302.00	Professional		$208.93	$239.88	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $97.72	Professional	26	$66.07	$77.62	$97.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $162.18 / $204.17	Professional	TC	$141.25	$162.18	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $346.74 / $426.58	Professional		$218.78	$346.74	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $141.25	Professional	26	$75.86	$87.10	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $245.47 / $338.84	Professional	TC	$144.54	$245.47	$338.84
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $354.81 / $645.65	Professional		$257.04	$354.81	$645.65
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $97.72 / $144.54	Professional	26	$74.13	$97.72	$144.54
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $257.04 / $512.86	Professional	TC	$177.83	$257.04	$512.86