Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $61.66 / $72.44	Facility	26	$54.95	$61.66	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $275.42 / $588.84	Professional		$177.83	$275.42	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $58.88 / $245.47	Professional	26	$50.12	$58.88	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $204.17 / $426.58	Professional	TC	$134.90	$204.17	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $295.12 / $467.74	Professional		$239.88	$295.12	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $123.03	Professional	26	$46.77	$69.18	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $234.42 / $346.74	Professional	TC	$190.55	$234.42	$346.74
HMSA Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $389.05 / $426.58	Professional		$91.20	$389.05	$426.58
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $74.13 / $77.62	Professional	26	$72.44	$74.13	$77.62
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $316.23	Professional	TC	$302.00	$302.00	$316.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $263.03 / $331.13	Professional		$229.09	$263.03	$331.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $64.57 / $81.28	Professional	26	$56.23	$64.57	$81.28
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $199.53 / $251.19	Professional	TC	$169.82	$199.53	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $446.68	Professional		$239.88	$331.13	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $117.49	Professional	26	$63.10	$72.44	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $245.47 / $346.74	Professional	TC	$177.83	$245.47	$346.74
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $354.81 / $630.96	Professional		$288.40	$354.81	$630.96
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $83.18 / $123.03	Professional	26	$61.66	$83.18	$123.03
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $288.40 / $524.81	Professional	TC	$218.78	$288.40	$524.81