Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.17 / $86.33 / $101.56	Facility	26	$76.17	$86.33	$101.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $340.04 / $343.57 / $418.50	Professional		$340.04	$343.57	$418.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $72.55 / $116.31	Professional	26	$62.17	$72.55	$116.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $277.86 / $279.64 / $345.93	Professional	TC	$277.86	$279.64	$345.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.25 / $87.25 / $87.25	Facility	26	$87.25	$87.25	$87.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.33 / $360.36 / $461.37	Professional		$298.33	$360.36	$461.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.06 / $84.92 / $108.63	Professional	26	$74.06	$84.92	$108.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.70 / $282.50 / $380.40	Professional	TC	$197.70	$282.50	$380.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $90.46 / $458.33 / $514.46	Professional		$90.46	$458.33	$514.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $99.15 / $103.82 / $106.42	Professional	26	$99.15	$103.82	$106.42
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 $264.26 / $288.29 / $336.34	Professional		$264.26	$288.29	$336.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $82.75 / $90.28 / $105.32	Professional	26	$82.75	$90.28	$105.32
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $181.51 / $198.01 / $209.56	Professional	TC	$181.51	$198.01	$209.56
United Facility/Professional Professional Modifier Low / Median / High Price $140.25 / $324.32 / $411.89	Professional		$140.25	$324.32	$411.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.18 / $101.56 / $128.52	Professional	26	$49.18	$101.56	$128.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.07 / $222.76 / $300.43	Professional	TC	$91.07	$222.76	$300.43
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $297.64 / $426.09 / $772.58	Professional		$297.64	$426.09	$772.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $110.79 / $186.96	Professional	26	$69.08	$110.79	$186.96
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $204.61 / $348.88 / $638.09	Professional	TC	$204.61	$348.88	$638.09