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 $415.80 / $475.00 / $522.50	Professional		$415.80	$475.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.14 / $140.00 / $154.00	Professional	26	$86.14	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $329.66 / $335.00 / $368.50	Professional	TC	$329.66	$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 $317.83 / $514.02 / $672.45	Professional		$317.83	$514.02	$672.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $66.40 / $82.42	Professional	26	$61.36	$66.40	$82.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.83 / $447.62 / $605.28	Professional	TC	$237.83	$447.62	$605.28
HMSA Facility/Professional Professional Modifier Low / Median / High Price $68.14 / $644.02 / $815.45	Professional		$68.14	$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 $275.29 / $300.31 / $350.36	Professional		$275.29	$300.31	$350.36
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 $214.01 / $233.46 / $247.08	Professional	TC	$214.01	$233.46	$247.08
United Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $337.85 / $568.96	Professional		$139.72	$337.85	$568.96
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 $105.04 / $262.64 / $479.09	Professional	TC	$105.04	$262.64	$479.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $310.12 / $617.24 / $957.41	Professional		$310.12	$617.24	$957.41
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $56.34 / $84.25 / $144.76	Professional	26	$56.34	$84.25	$144.76
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $241.24 / $551.53 / $844.27	Professional	TC	$241.24	$551.53	$844.27