Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.03 / $53.30 / $62.71	Facility	26	$47.03	$53.30	$62.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.92 / $221.44 / $272.42	Professional		$64.92	$221.44	$272.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.82 / $62.71 / $71.86	Professional	26	$43.82	$62.71	$71.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.61 / $206.54 / $221.14	Professional	TC	$177.61	$206.54	$221.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.28 / $252.53 / $319.77	Professional		$195.28	$252.53	$319.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.30 / $60.65 / $69.16	Professional	26	$53.30	$60.65	$69.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.93 / $191.95 / $258.39	Professional	TC	$148.93	$191.95	$258.39
HMSA Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $319.63 / $360.60	Professional		$61.92	$319.63	$360.60
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $67.87 / $71.06 / $72.84	Professional	26	$67.87	$71.06	$72.84
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $251.76 / $263.62 / $263.62	Professional	TC	$251.76	$263.62	$263.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $185.19 / $202.02 / $235.69	Professional		$185.19	$202.02	$235.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $55.74 / $65.03	Professional	26	$51.10	$55.74	$65.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.09 / $146.28 / $154.81	Professional	TC	$134.09	$146.28	$154.81
United Facility/Professional Professional Modifier Low / Median / High Price $102.01 / $227.27 / $302.42	Professional		$102.01	$227.27	$302.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.22 / $62.71 / $79.11	Professional	26	$30.22	$62.71	$79.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.79 / $164.57 / $223.31	Professional	TC	$71.79	$164.57	$223.31
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $208.59 / $291.35 / $497.32	Professional		$208.59	$291.35	$497.32
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $48.07 / $76.47 / $121.05	Professional	26	$48.07	$76.47	$121.05
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $151.16 / $228.74 / $397.40	Professional	TC	$151.16	$228.74	$397.40