Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.63 / $67.58 / $79.50	Facility	26	$59.63	$67.58	$79.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.00 / $342.37 / $342.37	Professional		$171.00	$342.37	$342.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $54.56 / $64.14	Professional	26	$51.30	$54.56	$64.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.70 / $287.81 / $287.81	Professional	TC	$119.70	$287.81	$287.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.70 / $68.70 / $68.70	Facility	26	$68.70	$68.70	$68.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.42 / $381.33 / $499.14	Professional		$285.42	$381.33	$499.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.25 / $70.73 / $86.81	Professional	26	$65.25	$70.73	$86.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $201.15 / $323.00 / $412.32	Professional	TC	$201.15	$323.00	$412.32
HMSA Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $528.72 / $643.29	Professional		$72.59	$528.72	$643.29
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $79.58 / $83.33 / $85.41	Professional	26	$79.58	$83.33	$85.41
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $449.14 / $470.30 / $470.30	Professional	TC	$449.14	$470.30	$470.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $236.48 / $257.98 / $300.97	Professional		$236.48	$257.98	$300.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.78 / $70.67 / $82.45	Professional	26	$64.78	$70.67	$82.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $171.70 / $187.31 / $198.23	Professional	TC	$171.70	$187.31	$198.23
United Facility/Professional Professional Modifier Low / Median / High Price $130.77 / $290.22 / $398.12	Professional		$130.77	$290.22	$398.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.11 / $79.50 / $99.75	Professional	26	$38.11	$79.50	$99.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.66 / $210.72 / $309.32	Professional	TC	$92.66	$210.72	$309.32
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $266.38 / $476.57 / $789.62	Professional		$266.38	$476.57	$789.62
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $60.07 / $91.43 / $152.97	Professional	26	$60.07	$91.43	$152.97
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $193.55 / $406.04 / $673.10	Professional	TC	$193.55	$406.04	$673.10