Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.78 / $64.34 / $75.70	Facility	26	$56.78	$64.34	$75.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.75 / $475.00 / $522.50	Professional		$393.75	$475.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.64 / $86.77 / $154.00	Professional	26	$78.64	$86.77	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.97 / $335.00 / $368.50	Professional	TC	$306.97	$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 $305.74 / $514.02 / $672.93	Professional		$305.74	$514.02	$672.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $66.40 / $82.96	Professional	26	$61.36	$66.40	$82.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $225.31 / $447.62 / $605.76	Professional	TC	$225.31	$447.62	$605.76
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 $260.98 / $284.70 / $332.15	Professional		$260.98	$284.70	$332.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.69 / $67.30 / $78.51	Professional	26	$61.69	$67.30	$78.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $199.29 / $217.40 / $230.09	Professional	TC	$199.29	$217.40	$230.09
United Facility/Professional Professional Modifier Low / Median / High Price $134.38 / $320.29 / $590.33	Professional		$134.38	$320.29	$590.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.86 / $75.70 / $95.31	Professional	26	$34.86	$75.70	$95.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.52 / $322.74 / $611.41	Professional	TC	$99.52	$322.74	$611.41
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $293.99 / $626.87 / $843.18	Professional		$293.99	$626.87	$843.18
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $56.72 / $84.80 / $145.71	Professional	26	$56.72	$84.80	$145.71
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $224.65 / $514.20 / $737.39	Professional	TC	$224.65	$514.20	$737.39