Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.43 / $65.09 / $76.56	Facility	26	$57.43	$65.09	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $282.06 / $303.73 / $347.11	Professional		$282.06	$303.73	$347.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $61.64 / $87.74	Professional	26	$52.78	$61.64	$87.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.99 / $229.28 / $285.48	Professional	TC	$215.99	$229.28	$285.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $65.98 / $65.98	Facility	26	$65.98	$65.98	$65.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $244.56 / $311.76 / $416.12	Professional		$244.56	$311.76	$416.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.85 / $67.62 / $83.91	Professional	26	$62.85	$67.62	$83.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.16 / $256.17 / $332.21	Professional	TC	$163.16	$256.17	$332.21
HMSA Facility/Professional Professional Modifier Low / Median / High Price $69.23 / $436.97 / $514.46	Professional		$69.23	$436.97	$514.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $75.89 / $79.47 / $81.45	Professional	26	$75.89	$79.47	$81.45
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 $202.61 / $221.03 / $257.87	Professional		$202.61	$221.03	$257.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.39 / $68.06 / $79.41	Professional	26	$62.39	$68.06	$79.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $140.22 / $152.96 / $161.88	Professional	TC	$140.22	$152.96	$161.88
United Facility/Professional Professional Modifier Low / Median / High Price $111.99 / $248.66 / $453.77	Professional		$111.99	$248.66	$453.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $76.56 / $96.41	Professional	26	$36.82	$76.56	$96.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.17 / $172.08 / $245.05	Professional	TC	$75.17	$172.08	$245.05
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $228.21 / $392.42 / $683.96	Professional		$228.21	$392.42	$683.96
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 $158.06 / $324.70 / $573.09	Professional	TC	$158.06	$324.70	$573.09