Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.90 / $97.35 / $114.53	Facility	26	$85.90	$97.35	$114.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.89 / $472.57 / $482.75	Professional		$392.89	$472.57	$482.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.23 / $118.64 / $289.08	Professional	26	$82.23	$118.64	$289.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $306.31 / $346.05 / $385.85	Professional	TC	$306.31	$346.05	$385.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.41 / $98.41 / $98.41	Facility	26	$98.41	$98.41	$98.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $340.61 / $496.23 / $639.60	Professional		$340.61	$496.23	$639.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $88.39 / $106.73 / $127.26	Professional	26	$88.39	$106.73	$127.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $241.00 / $407.83 / $507.69	Professional	TC	$241.00	$407.83	$507.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $108.08 / $739.34 / $889.29	Professional		$108.08	$739.34	$889.29
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $118.46 / $124.04 / $127.15	Professional	26	$118.46	$124.04	$127.15
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $620.88 / $650.14 / $650.14	Professional	TC	$620.88	$650.14	$650.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.97 / $346.87 / $404.68	Professional		$317.97	$346.87	$404.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.32 / $101.81 / $118.78	Professional	26	$93.32	$101.81	$118.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $224.63 / $245.05 / $285.89	Professional	TC	$224.63	$245.05	$285.89
United Facility/Professional Professional Modifier Low / Median / High Price $173.25 / $390.23 / $511.69	Professional		$173.25	$390.23	$511.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $114.53 / $143.75	Professional	26	$54.91	$114.53	$143.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $118.34 / $275.68 / $367.94	Professional	TC	$118.34	$275.68	$367.94
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $358.14 / $547.34 / $884.01	Professional		$358.14	$547.34	$884.01
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $85.84 / $132.02 / $219.51	Professional	26	$85.84	$132.02	$219.51
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $253.22 / $442.70 / $720.19	Professional	TC	$253.22	$442.70	$720.19