Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $57.54 / $67.61	Facility	26	$51.29	$57.54	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $213.80 / $707.95	Professional		$95.50	$213.80	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $54.95 / $204.17	Professional	26	$46.77	$54.95	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $128.82 / $316.23	Professional	TC	$91.20	$128.82	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $363.08	Professional		$194.98	$263.03	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $109.65	Professional	26	$41.69	$64.57	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $208.93 / $295.12	Professional	TC	$125.89	$208.93	$295.12
HMSA Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $389.05 / $426.58	Professional		$269.15	$389.05	$426.58
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Professional	26	$72.44	$74.13	$77.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $316.23	Professional	TC	$302.00	$302.00	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $173.78 / $218.78	Professional		$147.91	$173.78	$218.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $60.26 / $75.86	Professional	26	$51.29	$60.26	$75.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $112.20 / $141.25	Professional	TC	$97.72	$112.20	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $263.03 / $380.19	Professional		$158.49	$263.03	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $72.44 / $114.82	Professional	26	$58.88	$72.44	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $190.55 / $309.03	Professional	TC	$100.00	$190.55	$309.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $288.40 / $501.19	Professional		$186.21	$288.40	$501.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $79.43 / $123.03	Professional	26	$54.95	$79.43	$123.03
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $234.42 / $398.11	Professional	TC	$123.03	$234.42	$398.11