Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.49 / $95.76 / $112.66	Facility	26	$84.49	$95.76	$112.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $616.88	Professional		$475.00	$494.18	$616.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.78 / $140.00 / $154.00	Professional	26	$128.78	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $488.08	Professional	TC	$335.00	$348.53	$488.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.55 / $96.55 / $96.55	Facility	26	$96.55	$96.55	$96.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $439.90 / $547.54 / $695.61	Professional		$439.90	$547.54	$695.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.52 / $99.92 / $123.19	Professional	26	$92.52	$99.92	$123.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $359.98 / $447.62 / $594.66	Professional	TC	$359.98	$447.62	$594.66
HMSA Facility/Professional Professional Modifier Low / Median / High Price $106.19 / $685.73 / $815.45	Professional		$106.19	$685.73	$815.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $116.40 / $121.88 / $124.93	Professional	26	$116.40	$121.88	$124.93
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $569.33 / $596.16 / $596.16	Professional	TC	$569.33	$596.16	$596.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $408.62 / $445.76 / $520.05	Professional		$408.62	$445.76	$520.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.80 / $100.14 / $116.83	Professional	26	$91.80	$100.14	$116.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $316.82 / $345.62 / $365.79	Professional	TC	$316.82	$345.62	$365.79
United Facility/Professional Professional Modifier Low / Median / High Price $391.11 / $589.63 / $655.87	Professional		$391.11	$589.63	$655.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.45 / $112.66 / $140.18	Professional	26	$51.45	$112.66	$140.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.99 / $388.83 / $515.69	Professional	TC	$158.99	$388.83	$515.69
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $460.34 / $643.42 / $1,117.94	Professional		$460.34	$643.42	$1,117.94
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $84.77 / $129.83 / $214.06	Professional	26	$84.77	$129.83	$214.06
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $357.14 / $534.70 / $887.88	Professional	TC	$357.14	$534.70	$887.88