Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $76.92 / $87.18 / $102.56	Facility	26	$76.92	$87.18	$102.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $1,279.25	Professional		$475.00	$494.18	$1,279.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.56 / $140.00 / $154.00	Professional	26	$102.56	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $453.21	Professional	TC	$335.00	$348.53	$453.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.95 / $87.95 / $87.95	Facility	26	$87.95	$87.95	$87.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.54 / $550.62 / $705.00	Professional		$425.54	$550.62	$705.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.41 / $89.84 / $112.84	Professional	26	$74.41	$89.84	$112.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $344.88 / $476.21 / $592.16	Professional	TC	$344.88	$476.21	$592.16
HMSA Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $776.11 / $967.18	Professional		$92.00	$776.11	$967.18
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $100.85 / $105.60 / $108.24	Professional	26	$100.85	$105.60	$108.24
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $675.26 / $707.08 / $707.08	Professional	TC	$675.26	$707.08	$707.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $377.71 / $412.04 / $480.72	Professional		$377.71	$412.04	$480.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.57 / $91.16 / $106.36	Professional	26	$83.57	$91.16	$106.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $294.14 / $320.88 / $339.60	Professional	TC	$294.14	$320.88	$339.60
United Facility/Professional Professional Modifier Low / Median / High Price $199.62 / $463.55 / $623.41	Professional		$199.62	$463.55	$623.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.33 / $102.56 / $129.13	Professional	26	$47.33	$102.56	$129.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.29 / $360.99 / $494.28	Professional	TC	$152.29	$360.99	$494.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $425.52 / $669.13 / $1,002.39	Professional		$425.52	$669.13	$1,002.39
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $77.38 / $114.79 / $196.72	Professional	26	$77.38	$114.79	$196.72
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $331.58 / $533.24 / $847.76	Professional	TC	$331.58	$533.24	$847.76