Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.62 / $123.10 / $144.83	Facility	26	$108.62	$123.10	$144.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $498.46 / $738.63	Professional		$475.00	$498.46	$738.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.45 / $145.65 / $329.58	Professional	26	$109.45	$145.65	$329.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $407.82	Professional	TC	$335.00	$348.53	$407.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $124.22	Facility	26	$124.22	$124.22	$124.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $431.08 / $854.04 / $1,137.46	Professional		$431.08	$854.04	$1,137.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.10 / $143.11 / $160.91	Professional	26	$123.10	$143.11	$160.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $306.17 / $679.11 / $994.34	Professional	TC	$306.17	$679.11	$994.34
HMSA Facility/Professional Professional Modifier Low / Median / High Price $146.04 / $1,424.16 / $1,810.54	Professional		$146.04	$1,424.16	$1,810.54
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $160.08 / $167.62 / $171.81	Professional	26	$160.08	$167.62	$171.81
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $1,264.08 / $1,323.64 / $1,324.29	Professional	TC	$1,264.08	$1,323.64	$1,324.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $382.71 / $417.50 / $487.09	Professional		$382.71	$417.50	$487.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $118.01 / $128.74 / $150.19	Professional	26	$118.01	$128.74	$150.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $264.70 / $288.77 / $305.61	Professional	TC	$264.70	$288.77	$305.61
United Facility/Professional Professional Modifier Low / Median / High Price $201.62 / $469.69 / $620.35	Professional		$201.62	$469.69	$620.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.29 / $144.83 / $181.19	Professional	26	$66.29	$144.83	$181.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $135.33 / $324.86 / $439.16	Professional	TC	$135.33	$324.86	$439.16
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $431.05 / $859.00 / $1,621.69	Professional		$431.05	$859.00	$1,621.69
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $121.55 / $177.56 / $275.17	Professional	26	$121.55	$177.56	$275.17
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $298.39 / $667.32 / $1,436.23	Professional	TC	$298.39	$667.32	$1,436.23