Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.97 / $96.30 / $113.29	Facility	26	$84.97	$96.30	$113.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $522.50	Professional		$475.00	$494.18	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.48 / $140.00 / $154.00	Professional	26	$105.48	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $368.50	Professional	TC	$335.00	$348.53	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.16 / $97.16 / $97.16	Facility	26	$97.16	$97.16	$97.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $368.26 / $585.38 / $781.29	Professional		$368.26	$585.38	$781.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.30 / $107.12 / $125.88	Professional	26	$96.30	$107.12	$125.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $270.56 / $497.33 / $603.72	Professional	TC	$270.56	$497.33	$603.72
HMSA Facility/Professional Professional Modifier Low / Median / High Price $109.96 / $802.80 / $977.21	Professional		$109.96	$802.80	$977.21
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $120.53 / $126.21 / $129.36	Professional	26	$120.53	$126.21	$129.36
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $682.27 / $714.42 / $714.42	Professional	TC	$682.27	$714.42	$714.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $330.44 / $360.48 / $420.56	Professional		$330.44	$360.48	$420.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $92.31 / $100.70 / $117.49	Professional	26	$92.31	$100.70	$117.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $238.13 / $259.77 / $274.93	Professional	TC	$238.13	$259.77	$274.93
United Facility/Professional Professional Modifier Low / Median / High Price $172.66 / $405.54 / $533.66	Professional		$172.66	$405.54	$533.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $113.29 / $141.57	Professional	26	$51.80	$113.29	$141.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.86 / $292.25 / $392.09	Professional	TC	$120.86	$292.25	$392.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $372.21 / $724.30 / $997.28	Professional		$372.21	$724.30	$997.28
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $91.07 / $137.34 / $216.18	Professional	26	$91.07	$137.34	$216.18
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $268.44 / $572.52 / $834.69	Professional	TC	$268.44	$572.52	$834.69