Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.38 / $71.83 / $84.51	Facility	26	$63.38	$71.83	$84.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $409.82 / $475.00 / $608.00	Professional		$409.82	$475.00	$608.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.51 / $140.00 / $154.00	Professional	26	$84.51	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $313.07 / $335.00 / $368.50	Professional	TC	$313.07	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.27 / $494.51 / $651.47	Professional		$324.27	$494.51	$651.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.62 / $74.84 / $92.56	Professional	26	$64.62	$74.84	$92.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.81 / $432.83 / $558.91	Professional	TC	$234.81	$432.83	$558.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $76.02 / $646.37 / $806.44	Professional		$76.02	$646.37	$806.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $83.33 / $87.26 / $89.43	Professional	26	$83.33	$87.26	$89.43
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $563.04 / $589.57 / $589.57	Professional	TC	$563.04	$589.57	$589.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.02 / $296.76 / $346.22	Professional		$272.02	$296.76	$346.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.86 / $75.12 / $87.64	Professional	26	$68.86	$75.12	$87.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $203.18 / $221.65 / $234.58	Professional	TC	$203.18	$221.65	$234.58
United Facility/Professional Professional Modifier Low / Median / High Price $142.47 / $333.86 / $528.24	Professional		$142.47	$333.86	$528.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.76 / $84.51 / $105.96	Professional	26	$38.76	$84.51	$105.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.71 / $249.36 / $427.35	Professional	TC	$103.71	$249.36	$427.35
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $306.44 / $573.74 / $860.51	Professional		$306.44	$573.74	$860.51
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $63.60 / $94.64 / $162.44	Professional	26	$63.60	$94.64	$162.44
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $229.04 / $490.33 / $734.12	Professional	TC	$229.04	$490.33	$734.12