Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.70 / $78.98 / $92.93	Facility	26	$69.70	$78.98	$92.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $606.46	Professional		$475.00	$494.18	$606.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.43 / $140.00 / $231.92	Professional	26	$74.43	$140.00	$231.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $500.05	Professional	TC	$335.00	$348.53	$500.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.26 / $80.26 / $80.26	Facility	26	$80.26	$80.26	$80.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $459.65 / $876.87 / $1,113.50	Professional		$459.65	$876.87	$1,113.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.98 / $99.92 / $110.45	Professional	26	$78.98	$99.92	$110.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $360.42 / $794.16 / $989.44	Professional	TC	$360.42	$794.16	$989.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $102.56 / $1,232.78 / $1,604.35	Professional		$102.56	$1,232.78	$1,604.35
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $112.42 / $117.72 / $120.66	Professional	26	$112.42	$117.72	$120.66
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $1,120.13 / $1,172.91 / $1,172.91	Professional	TC	$1,120.13	$1,172.91	$1,172.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $400.31 / $436.70 / $509.49	Professional		$400.31	$436.70	$509.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.72 / $82.61 / $96.38	Professional	26	$75.72	$82.61	$96.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $324.58 / $354.10 / $374.75	Professional	TC	$324.58	$354.10	$374.75
United Facility/Professional Professional Modifier Low / Median / High Price $202.23 / $491.29 / $880.20	Professional		$202.23	$491.29	$880.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.05 / $92.93 / $135.10	Professional	26	$43.05	$92.93	$135.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.18 / $516.29 / $745.10	Professional	TC	$159.18	$516.29	$745.10
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $451.03 / $984.48 / $1,479.60	Professional		$451.03	$984.48	$1,479.60
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $84.99 / $115.10 / $182.94	Professional	26	$84.99	$115.10	$182.94
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $365.90 / $868.68 / $1,346.58	Professional	TC	$365.90	$868.68	$1,346.58