Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.13 / $72.68 / $85.51	Facility	26	$64.13	$72.68	$85.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.83 / $322.58 / $963.49	Professional		$68.83	$322.58	$963.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.65 / $98.01 / $314.61	Professional	26	$62.65	$98.01	$314.61
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $125.00 / $125.00 / $125.00	Professional	52	$125.00	$125.00	$125.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.50 / $335.00 / $368.50	Professional	TC	$158.50	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.64 / $73.64 / $73.64	Facility	26	$73.64	$73.64	$73.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $267.33 / $439.60 / $562.01	Professional		$267.33	$439.60	$562.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.71 / $74.84 / $94.85	Professional	26	$61.71	$74.84	$94.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $193.35 / $344.75 / $442.29	Professional	TC	$193.35	$344.75	$442.29
HMSA Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $673.30 / $806.44	Professional		$79.19	$673.30	$806.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $86.80 / $90.89 / $93.16	Professional	26	$86.80	$90.89	$93.16
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $586.50 / $614.14 / $614.14	Professional	TC	$586.50	$614.14	$614.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $244.02 / $266.20 / $310.58	Professional		$244.02	$266.20	$310.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.67 / $76.01 / $88.68	Professional	26	$69.67	$76.01	$88.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $174.35 / $190.20 / $201.30	Professional	TC	$174.35	$190.20	$201.30
United Facility/Professional Professional Modifier Low / Median / High Price $125.32 / $299.48 / $386.58	Professional		$125.32	$299.48	$386.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.14 / $85.51 / $107.19	Professional	26	$39.14	$85.51	$107.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.18 / $213.98 / $279.39	Professional	TC	$86.18	$213.98	$279.39
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $274.87 / $574.25 / $837.57	Professional		$274.87	$574.25	$837.57
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $64.79 / $95.76 / $164.36	Professional	26	$64.79	$95.76	$164.36
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $196.54 / $453.63 / $714.53	Professional	TC	$196.54	$453.63	$714.53