Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $53.70 / $63.10	Facility	26	$46.77	$53.70	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $616.60	Professional		$141.25	$223.87	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $54.95 / $251.19	Professional	26	$45.71	$54.95	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $138.04 / $316.23	Professional	TC	$91.20	$138.04	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $389.05	Professional		$190.55	$263.03	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $112.20	Professional	26	$42.66	$63.10	$112.20
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 $275.42 / $389.05 / $426.58	Professional		$275.42	$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 / $169.82 / $213.80	Professional		$147.91	$169.82	$213.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $56.23 / $70.79	Professional	26	$48.98	$56.23	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $114.82 / $144.54	Professional	TC	$97.72	$114.82	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $269.15 / $380.19	Professional		$154.88	$269.15	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $102.33	Professional	26	$54.95	$72.44	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $190.55 / $309.03	Professional	TC	$102.33	$190.55	$309.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $295.12 / $501.19	Professional		$181.97	$295.12	$501.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $77.62 / $117.49	Professional	26	$57.54	$77.62	$117.49
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