Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.45 / $95.71 / $112.60	Facility	26	$84.45	$95.71	$112.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $606.86	Professional		$475.00	$494.18	$606.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.41 / $140.00 / $154.00	Professional	26	$83.41	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $478.00	Professional	TC	$335.00	$348.53	$478.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.95 / $96.95 / $96.95	Facility	26	$96.95	$96.95	$96.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.60 / $548.24 / $701.35	Professional		$439.60	$548.24	$701.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.65 / $100.72 / $124.20	Professional	26	$93.65	$100.72	$124.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $356.82 / $447.62 / $599.00	Professional	TC	$356.82	$447.62	$599.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $682.18 / $815.45	Professional		$102.95	$682.18	$815.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $112.85 / $118.17 / $121.12	Professional	26	$112.85	$118.17	$121.12
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 $402.04 / $438.59 / $511.69	Professional		$402.04	$438.59	$511.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.75 / $100.09 / $116.77	Professional	26	$91.75	$100.09	$116.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $310.27 / $338.48 / $358.23	Professional	TC	$310.27	$338.48	$358.23
United Facility/Professional Professional Modifier Low / Median / High Price $209.51 / $584.49 / $652.70	Professional		$209.51	$584.49	$652.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.85 / $112.60 / $141.35	Professional	26	$51.85	$112.60	$141.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $157.66 / $380.79 / $511.35	Professional	TC	$157.66	$380.79	$511.35
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $452.91 / $700.56 / $1,047.56	Professional		$452.91	$700.56	$1,047.56
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $85.84 / $133.90 / $216.27	Professional	26	$85.84	$133.90	$216.27
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $349.77 / $548.85 / $844.49	Professional	TC	$349.77	$548.85	$844.49