Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $62.01 / $72.95	Facility	26	$54.72	$62.01	$72.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.55 / $322.50 / $414.92	Professional		$267.55	$322.50	$414.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $58.49 / $75.80	Professional	26	$50.07	$58.49	$75.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $212.81 / $266.89 / $331.34	Professional	TC	$212.81	$266.89	$331.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.89 / $62.89 / $62.89	Facility	26	$62.89	$62.89	$62.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.99 / $336.85 / $408.75	Professional		$256.99	$336.85	$408.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.53 / $64.34 / $79.98	Professional	26	$59.53	$64.34	$79.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.77 / $273.36 / $343.80	Professional	TC	$193.77	$273.36	$343.80
HMSA Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $419.80 / $498.30	Professional		$65.59	$419.80	$498.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $71.90 / $75.29 / $77.17	Professional	26	$71.90	$75.29	$77.17
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $347.90 / $364.29 / $364.29	Professional	TC	$347.90	$364.29	$364.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $274.47 / $299.42 / $349.33	Professional		$274.47	$299.42	$349.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.44 / $64.84 / $75.66	Professional	26	$59.44	$64.84	$75.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $215.04 / $234.59 / $248.27	Professional	TC	$215.04	$234.59	$248.27
United Facility/Professional Professional Modifier Low / Median / High Price $137.69 / $336.85 / $411.46	Professional		$137.69	$336.85	$411.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.63 / $87.90 / $439.88	Professional	26	$52.63	$87.90	$439.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.80 / $263.91 / $319.91	Professional	TC	$102.80	$263.91	$319.91
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $294.39 / $429.26 / $690.08	Professional		$294.39	$429.26	$690.08
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $55.06 / $83.33 / $140.51	Professional	26	$55.06	$83.33	$140.51
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $239.32 / $335.35 / $572.28	Professional	TC	$239.32	$335.35	$572.28