Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.61 / $65.29 / $76.81	Facility	26	$57.61	$65.29	$76.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.68 / $305.20 / $347.89	Professional		$282.68	$305.20	$347.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $87.94	Professional	26	$52.78	$61.64	$87.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $217.25 / $229.91 / $286.25	Professional	TC	$217.25	$229.91	$286.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.34 / $66.34 / $66.34	Facility	26	$66.34	$66.34	$66.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.86 / $312.44 / $417.21	Professional		$245.86	$312.44	$417.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.85 / $67.88 / $83.91	Professional	26	$62.85	$67.88	$83.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $164.46 / $256.51 / $333.30	Professional	TC	$164.46	$256.51	$333.30
HMSA Facility/Professional Professional Modifier Low / Median / High Price $68.93 / $434.73 / $514.46	Professional		$68.93	$434.73	$514.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $75.55 / $79.11 / $81.09	Professional	26	$75.55	$79.11	$81.09
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $359.18 / $376.10 / $376.10	Professional	TC	$359.18	$376.10	$376.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $203.63 / $222.14 / $259.17	Professional		$203.63	$222.14	$259.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.59 / $68.28 / $79.66	Professional	26	$62.59	$68.28	$79.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.03 / $153.85 / $162.83	Professional	TC	$141.03	$153.85	$162.83
United Facility/Professional Professional Modifier Low / Median / High Price $112.59 / $249.91 / $337.53	Professional		$112.59	$249.91	$337.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $76.81 / $96.41	Professional	26	$36.82	$76.81	$96.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.77 / $173.08 / $246.09	Professional	TC	$75.77	$173.08	$246.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $229.35 / $391.65 / $684.78	Professional		$229.35	$391.65	$684.78
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $87.08 / $147.38	Professional	26	$57.72	$87.08	$147.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $158.97 / $324.70 / $573.09	Professional	TC	$158.97	$324.70	$573.09