Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.07 / $63.55 / $74.76	Facility	26	$56.07	$63.55	$74.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.90 / $241.56 / $274.81	Professional		$223.90	$241.56	$274.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.28 / $59.87 / $85.66	Professional	26	$51.28	$59.87	$85.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.88 / $172.62 / $214.94	Professional	TC	$155.88	$172.62	$214.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.44 / $64.44 / $64.44	Facility	26	$64.44	$64.44	$64.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.10 / $253.39 / $292.24	Professional		$169.10	$253.39	$292.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.00 / $65.98 / $81.94	Professional	26	$61.00	$65.98	$81.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.55 / $195.97 / $226.26	Professional	TC	$105.55	$195.97	$226.26
HMSA Facility/Professional Professional Modifier Low / Median / High Price $67.26 / $361.01 / $411.48	Professional		$67.26	$361.01	$411.48
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $73.73 / $77.20 / $79.13	Professional	26	$73.73	$77.20	$79.13
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $287.27 / $300.82 / $300.82	Professional	TC	$287.27	$300.82	$300.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.10 / $176.83 / $206.30	Professional		$162.10	$176.83	$206.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.92 / $66.45 / $77.53	Professional	26	$60.92	$66.45	$77.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.18 / $110.38 / $116.81	Professional	TC	$101.18	$110.38	$116.81
United Facility/Professional Professional Modifier Low / Median / High Price $85.89 / $198.94 / $249.32	Professional		$85.89	$198.94	$249.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.97 / $74.76 / $94.14	Professional	26	$35.97	$74.76	$94.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.92 / $124.17 / $155.18	Professional	TC	$49.92	$124.17	$155.18
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $182.54 / $325.22 / $505.20	Professional		$182.54	$325.22	$505.20
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $56.39 / $85.20 / $143.93	Professional	26	$56.39	$85.20	$143.93
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $114.06 / $218.06 / $395.73	Professional	TC	$114.06	$218.06	$395.73