Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.49 / $93.49 / $109.98	Facility	26	$82.49	$93.49	$109.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $385.88 / $464.81 / $1,138.55	Professional		$385.88	$464.81	$1,138.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.47 / $116.76 / $281.35	Professional	26	$81.47	$116.76	$281.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $310.24 / $346.05 / $386.24	Professional	TC	$310.24	$346.05	$386.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.56 / $94.56 / $94.56	Facility	26	$94.56	$94.56	$94.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $335.49 / $521.28 / $694.01	Professional		$335.49	$521.28	$694.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.33 / $97.07 / $120.28	Professional	26	$90.33	$97.07	$120.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.75 / $424.22 / $577.37	Professional	TC	$239.75	$424.22	$577.37
HMSA Facility/Professional Professional Modifier Low / Median / High Price $99.19 / $647.95 / $772.34	Professional		$99.19	$647.95	$772.34
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $108.72 / $113.84 / $116.69	Professional	26	$108.72	$113.84	$116.69
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $539.23 / $564.64 / $564.64	Professional	TC	$539.23	$564.64	$564.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $314.26 / $342.83 / $399.97	Professional		$314.26	$342.83	$399.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.62 / $97.76 / $114.06	Professional	26	$89.62	$97.76	$114.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $224.63 / $245.05 / $259.35	Professional	TC	$224.63	$245.05	$259.35
United Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $385.68 / $501.07	Professional		$169.54	$385.68	$501.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.80 / $109.98 / $138.08	Professional	26	$52.80	$109.98	$138.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $116.74 / $275.68 / $362.99	Professional	TC	$116.74	$275.68	$362.99
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $353.97 / $590.82 / $845.29	Professional		$353.97	$590.82	$845.29
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $82.80 / $124.64 / $210.86	Professional	26	$82.80	$124.64	$210.86
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $253.22 / $487.87 / $699.66	Professional	TC	$253.22	$487.87	$699.66