Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.90 / $100.75 / $118.53	Facility	26	$88.90	$100.75	$118.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $392.31 / $471.94 / $482.09	Professional		$392.31	$471.94	$482.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.39 / $91.52 / $240.10	Professional	26	$82.39	$91.52	$240.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.93 / $345.42 / $385.85	Professional	TC	$309.93	$345.42	$385.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.96 / $101.96 / $101.96	Facility	26	$101.96	$101.96	$101.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $379.00 / $480.93 / $642.47	Professional		$379.00	$480.93	$642.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $105.51 / $130.41	Professional	26	$87.82	$105.51	$130.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.18 / $393.11 / $512.04	Professional	TC	$275.18	$393.11	$512.04
HMSA Facility/Professional Professional Modifier Low / Median / High Price $107.24 / $668.73 / $789.46	Professional		$107.24	$668.73	$789.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $117.55 / $123.09 / $126.17	Professional	26	$117.55	$123.09	$126.17
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $551.17 / $577.15 / $577.15	Professional	TC	$551.17	$577.15	$577.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $320.82 / $349.98 / $408.31	Professional		$320.82	$349.98	$408.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $96.58 / $105.36 / $122.92	Professional	26	$96.58	$105.36	$122.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $224.22 / $244.61 / $258.88	Professional	TC	$224.22	$244.61	$258.88
United Facility/Professional Professional Modifier Low / Median / High Price $202.65 / $397.06 / $601.86	Professional		$202.65	$397.06	$601.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.65 / $118.53 / $148.11	Professional	26	$56.65	$118.53	$148.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $146.00 / $376.57 / $453.75	Professional	TC	$146.00	$376.57	$453.75
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $361.34 / $541.53 / $892.38	Professional		$361.34	$541.53	$892.38
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $85.84 / $132.37 / $227.59	Professional	26	$85.84	$132.37	$227.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $252.76 / $439.69 / $683.78	Professional	TC	$252.76	$439.69	$683.78