Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.73 / $80.16 / $94.31	Facility	26	$70.73	$80.16	$94.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $446.48 / $475.00 / $522.50	Professional		$446.48	$475.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.93 / $140.00 / $154.00	Professional	26	$97.93	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $286.23 / $335.00 / $368.50	Professional	TC	$286.23	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.40 / $81.40 / $81.40	Facility	26	$81.40	$81.40	$81.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.35 / $514.02 / $682.58	Professional		$342.35	$514.02	$682.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.36 / $70.51 / $100.21	Professional	26	$61.36	$70.51	$100.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.15 / $447.62 / $615.41	Professional	TC	$242.15	$447.62	$615.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $84.22 / $661.64 / $815.45	Professional		$84.22	$661.64	$815.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $92.31 / $96.66 / $99.08	Professional	26	$92.31	$96.66	$99.08
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 $296.57 / $323.52 / $377.45	Professional		$296.57	$323.52	$377.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.84 / $83.83 / $97.80	Professional	26	$76.84	$83.83	$97.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $219.73 / $239.70 / $253.68	Professional	TC	$219.73	$239.70	$253.68
United Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $363.97 / $607.11	Professional		$150.41	$363.97	$607.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.93 / $94.31 / $568.59	Professional	26	$75.93	$94.31	$568.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $106.94 / $269.66 / $516.72	Professional	TC	$106.94	$269.66	$516.72
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $334.08 / $662.87 / $958.53	Professional		$334.08	$662.87	$958.53
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $64.14 / $102.74 / $157.46	Professional	26	$64.14	$102.74	$157.46
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $247.69 / $566.89 / $845.39	Professional	TC	$247.69	$566.89	$845.39