Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $67.61 / $79.43	Facility	26	$60.26	$67.61	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $281.84 / $436.52	Professional		$208.93	$281.84	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $64.57 / $107.15	Professional	26	$51.29	$64.57	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $213.80 / $371.54	Professional	TC	$144.54	$213.80	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $380.19 / $575.44	Professional		$288.40	$380.19	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $134.90	Professional	26	$51.29	$74.13	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $323.59 / $446.68	Professional	TC	$208.93	$323.59	$446.68
HMSA Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $575.44 / $645.65	Professional		$398.11	$575.44	$645.65
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $81.28 / $85.11	Professional	26	$79.43	$81.28	$85.11
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $446.68 / $446.68 / $467.74	Professional	TC	$446.68	$446.68	$467.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $257.04 / $323.59	Professional		$223.87	$257.04	$323.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $70.79 / $89.13	Professional	26	$60.26	$70.79	$89.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $186.21 / $234.42	Professional	TC	$162.18	$186.21	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $398.11 / $562.34	Professional		$239.88	$398.11	$562.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $128.82	Professional	26	$69.18	$79.43	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $302.00 / $478.63	Professional	TC	$165.96	$302.00	$478.63
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $436.52 / $794.33	Professional		$281.84	$436.52	$794.33
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $91.20 / $131.83	Professional	26	$67.61	$91.20	$131.83
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $363.08 / $676.08	Professional	TC	$204.17	$363.08	$676.08