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 $242.23 / $328.23 / $363.23	Professional		$242.23	$328.23	$363.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.07 / $55.59 / $83.57	Professional	26	$50.07	$55.59	$83.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $181.61 / $272.63 / $279.64	Professional	TC	$181.61	$272.63	$279.64
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 $251.36 / $300.51 / $376.87	Professional		$251.36	$300.51	$376.87
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 $190.03 / $236.16 / $311.92	Professional	TC	$190.03	$236.16	$311.92
HMSA Facility/Professional Professional Modifier Low / Median / High Price $66.08 / $372.48 / $429.76	Professional		$66.08	$372.48	$429.76
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $72.43 / $75.84 / $77.73	Professional	26	$72.43	$75.84	$77.73
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $300.05 / $314.19 / $314.19	Professional	TC	$300.05	$314.19	$314.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $240.96 / $262.86 / $306.67	Professional		$240.96	$262.86	$306.67
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 $181.51 / $198.01 / $209.56	Professional	TC	$181.51	$198.01	$209.56
United Facility/Professional Professional Modifier Low / Median / High Price $126.76 / $295.72 / $377.39	Professional		$126.76	$295.72	$377.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $72.95 / $91.55	Professional	26	$34.89	$72.95	$91.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.87 / $222.76 / $285.83	Professional	TC	$91.87	$222.76	$285.83
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $271.44 / $390.41 / $623.84	Professional		$271.44	$390.41	$623.84
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 $204.61 / $297.14 / $523.51	Professional	TC	$204.61	$297.14	$523.51