Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.45 / $92.32 / $108.61	Facility	26	$81.45	$92.32	$108.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $484.91 / $522.50	Professional		$475.00	$484.91	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.36 / $140.00 / $154.00	Professional	26	$124.36	$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 $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $386.79 / $573.49 / $754.00	Professional		$386.79	$573.49	$754.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.51 / $96.23 / $119.34	Professional	26	$83.51	$96.23	$119.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $271.07 / $494.13 / $634.66	Professional	TC	$271.07	$494.13	$634.66
HMSA Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $783.60 / $969.31	Professional		$97.48	$783.60	$969.31
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $106.85 / $111.88 / $114.68	Professional	26	$106.85	$111.88	$114.68
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $676.75 / $708.64 / $708.64	Professional	TC	$676.75	$708.64	$708.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $322.54 / $351.86 / $410.51	Professional		$322.54	$351.86	$410.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.50 / $96.54 / $112.63	Professional	26	$88.50	$96.54	$112.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $234.04 / $255.31 / $270.20	Professional	TC	$234.04	$255.31	$270.20
United Facility/Professional Professional Modifier Low / Median / High Price $169.90 / $395.85 / $617.76	Professional		$169.90	$395.85	$617.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.19 / $108.61 / $136.97	Professional	26	$50.19	$108.61	$136.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.71 / $388.38 / $474.90	Professional	TC	$119.71	$388.38	$474.90
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $363.31 / $705.97 / $1,010.02	Professional		$363.31	$705.97	$1,010.02
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $82.16 / $121.86 / $209.21	Professional	26	$82.16	$121.86	$209.21
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $263.82 / $608.16 / $847.17	Professional	TC	$263.82	$608.16	$847.17