Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.04 / $78.25 / $92.06	Facility	26	$69.04	$78.25	$92.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $450.76 / $475.00 / $575.65	Professional		$450.76	$475.00	$575.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.17 / $140.00 / $154.00	Professional	26	$96.17	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $470.23	Professional	TC	$335.00	$348.53	$470.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.14 / $524.86 / $687.48	Professional		$450.14	$524.86	$687.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $80.97 / $99.93	Professional	26	$72.18	$80.97	$99.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $374.53 / $443.89 / $606.07	Professional	TC	$374.53	$443.89	$606.07
HMSA Facility/Professional Professional Modifier Low / Median / High Price $82.29 / $655.10 / $809.13	Professional		$82.29	$655.10	$809.13
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $90.19 / $94.44 / $96.81	Professional	26	$90.19	$94.44	$96.81
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $564.91 / $591.53 / $591.53	Professional	TC	$564.91	$591.53	$591.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $414.76 / $483.88	Professional		$380.19	$414.76	$483.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.01 / $81.83 / $95.47	Professional	26	$75.01	$81.83	$95.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $305.17 / $332.92 / $352.34	Professional	TC	$305.17	$332.92	$352.34
United Facility/Professional Professional Modifier Low / Median / High Price $215.50 / $466.60 / $677.52	Professional		$215.50	$466.60	$677.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $92.06 / $115.74	Professional	26	$42.44	$92.06	$115.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.06 / $499.48 / $561.78	Professional	TC	$173.06	$499.48	$561.78
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $417.99 / $659.79 / $910.14	Professional		$417.99	$659.79	$910.14
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $68.61 / $106.53 / $176.32	Professional	26	$68.61	$106.53	$176.32
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $331.03 / $569.02 / $738.63	Professional	TC	$331.03	$569.02	$738.63