Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.43 / $65.09 / $76.56	Facility	26	$57.43	$65.09	$76.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $343.39 / $415.33 / $433.59	Professional		$343.39	$415.33	$433.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $58.24 / $87.74	Professional	26	$52.46	$58.24	$87.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $290.93 / $345.83 / $362.21	Professional	TC	$290.93	$345.83	$362.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.64 / $65.64 / $65.64	Facility	26	$65.64	$65.64	$65.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.22 / $391.14 / $488.60	Professional		$299.22	$391.14	$488.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.47 / $67.62 / $83.91	Professional	26	$62.47	$67.62	$83.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.12 / $318.42 / $404.69	Professional	TC	$234.12	$318.42	$404.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $72.98 / $506.21 / $616.83	Professional		$72.98	$506.21	$616.83
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $75.55 / $79.11 / $81.09	Professional	26	$75.55	$79.11	$81.09
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $430.66 / $450.95 / $450.95	Professional	TC	$430.66	$450.95	$450.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $286.83 / $312.91 / $365.06	Professional		$286.83	$312.91	$365.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.39 / $68.06 / $79.41	Professional	26	$62.39	$68.06	$79.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $224.43 / $244.84 / $259.12	Professional	TC	$224.43	$244.84	$259.12
United Facility/Professional Professional Modifier Low / Median / High Price $154.76 / $352.03 / $463.10	Professional		$154.76	$352.03	$463.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $76.56 / $96.41	Professional	26	$36.82	$76.56	$96.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.94 / $292.07 / $366.69	Professional	TC	$117.94	$292.07	$366.69
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $323.14 / $456.59 / $784.55	Professional		$323.14	$456.59	$784.55
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $57.72 / $87.08 / $147.38	Professional	26	$57.72	$87.08	$147.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $253.00 / $389.21 / $673.68	Professional	TC	$253.00	$389.21	$673.68