Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.76 / $72.26 / $85.01	Facility	26	$63.76	$72.26	$85.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.85 / $475.00 / $884.45	Professional		$328.85	$475.00	$884.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.61 / $132.13 / $154.00	Professional	26	$80.61	$132.13	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $262.42 / $335.00 / $368.50	Professional	TC	$262.42	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.95 / $72.95	Facility	26	$72.95	$72.95	$72.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $320.39 / $496.22 / $656.17	Professional		$320.39	$496.22	$656.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.68 / $74.84 / $93.10	Professional	26	$61.68	$74.84	$93.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $230.49 / $434.54 / $571.45	Professional	TC	$230.49	$434.54	$571.45
HMSA Facility/Professional Professional Modifier Low / Median / High Price $76.02 / $646.37 / $806.44	Professional		$76.02	$646.37	$806.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $83.33 / $87.26 / $89.43	Professional	26	$83.33	$87.26	$89.43
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $563.04 / $589.57 / $589.57	Professional	TC	$563.04	$589.57	$589.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $267.95 / $292.31 / $341.03	Professional		$267.95	$292.31	$341.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.27 / $75.56 / $88.16	Professional	26	$69.27	$75.56	$88.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $198.68 / $216.74 / $229.39	Professional	TC	$198.68	$216.74	$229.39
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $313.98 / $536.08	Professional		$86.60	$313.98	$536.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $85.01 / $106.58	Professional	26	$38.95	$85.01	$106.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.80 / $243.84 / $434.67	Professional	TC	$101.80	$243.84	$434.67
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $301.83 / $581.70 / $860.51	Professional		$301.83	$581.70	$860.51
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $63.60 / $95.20 / $163.38	Professional	26	$63.60	$95.20	$163.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $223.97 / $507.79 / $734.12	Professional	TC	$223.97	$507.79	$734.12