Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.40 / $63.92 / $75.20	Facility	26	$56.40	$63.92	$75.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.72 / $475.00 / $522.50	Professional		$253.72	$475.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.64 / $113.02 / $154.00	Professional	26	$78.64	$113.02	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.40 / $335.00 / $368.50	Professional	TC	$129.40	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.84 / $64.84 / $64.84	Facility	26	$64.84	$64.84	$64.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $304.45 / $514.40 / $673.41	Professional		$304.45	$514.40	$673.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $66.78 / $82.42	Professional	26	$61.36	$66.78	$82.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.45 / $447.62 / $605.76	Professional	TC	$224.45	$447.62	$605.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $69.75 / $644.02 / $815.45	Professional		$69.75	$644.02	$815.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $74.69 / $78.20 / $80.17	Professional	26	$74.69	$78.20	$80.17
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $569.33 / $596.16 / $596.16	Professional	TC	$569.33	$596.16	$596.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $260.14 / $283.80 / $331.10	Professional		$260.14	$283.80	$331.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.27 / $66.84 / $77.98	Professional	26	$61.27	$66.84	$77.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $198.88 / $216.96 / $229.62	Professional	TC	$198.88	$216.96	$229.62
United Facility/Professional Professional Modifier Low / Median / High Price $133.82 / $319.27 / $576.26	Professional		$133.82	$319.27	$576.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.69 / $75.20 / $94.70	Professional	26	$34.69	$75.20	$94.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.13 / $244.08 / $485.87	Professional	TC	$99.13	$244.08	$485.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $293.07 / $627.70 / $844.00	Professional		$293.07	$627.70	$844.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $56.72 / $84.80 / $144.76	Professional	26	$56.72	$84.80	$144.76
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $224.19 / $514.20 / $737.39	Professional	TC	$224.19	$514.20	$737.39