Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.98 / $66.84 / $78.64	Facility	26	$58.98	$66.84	$78.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $305.62 / $347.48 / $427.97	Professional		$305.62	$347.48	$427.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.34 / $65.91 / $136.12	Professional	26	$59.34	$65.91	$136.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $214.94 / $288.12 / $358.73	Professional	TC	$214.94	$288.12	$358.73
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.54 / $67.54 / $67.54	Facility	26	$67.54	$67.54	$67.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $287.52 / $386.17 / $505.42	Professional		$287.52	$386.17	$505.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.84 / $76.48 / $91.79	Professional	26	$66.84	$76.48	$91.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.70 / $322.66 / $410.69	Professional	TC	$197.70	$322.66	$410.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $535.05 / $643.29	Professional		$80.23	$535.05	$643.29
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $85.92 / $89.97 / $92.22	Professional	26	$85.92	$89.97	$92.22
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $449.14 / $470.30 / $470.30	Professional	TC	$449.14	$470.30	$470.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $235.77 / $257.20 / $300.08	Professional		$235.77	$257.20	$300.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.08 / $69.90 / $81.55	Professional	26	$64.08	$69.90	$81.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $171.70 / $187.31 / $198.23	Professional	TC	$171.70	$187.31	$198.23
United Facility/Professional Professional Modifier Low / Median / High Price $132.57 / $289.36 / $405.01	Professional		$132.57	$289.36	$405.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.49 / $78.64 / $108.83	Professional	26	$41.49	$78.64	$108.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.08 / $210.72 / $301.47	Professional	TC	$91.08	$210.72	$301.47
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $265.57 / $482.21 / $799.87	Professional		$265.57	$482.21	$799.87
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $65.08 / $99.09 / $161.27	Professional	26	$65.08	$99.09	$161.27
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $193.55 / $386.60 / $673.10	Professional	TC	$193.55	$386.60	$673.10