Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.01 / $68.01 / $80.01	Facility	26	$60.01	$68.01	$80.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $303.77 / $357.42 / $420.44	Professional		$303.77	$357.42	$420.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.86 / $83.13 / $175.49	Professional	26	$54.86	$83.13	$175.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $248.90 / $305.50 / $328.82	Professional	TC	$248.90	$305.50	$328.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.05 / $69.05 / $69.05	Facility	26	$69.05	$69.05	$69.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.30 / $344.10 / $429.41	Professional		$266.30	$344.10	$429.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.63 / $70.73 / $87.90	Professional	26	$65.63	$70.73	$87.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $215.54 / $273.36 / $354.01	Professional	TC	$215.54	$273.36	$354.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $72.13 / $426.96 / $498.30	Professional		$72.13	$426.96	$498.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $79.06 / $82.79 / $84.86	Professional	26	$79.06	$82.79	$84.86
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $347.90 / $364.29 / $364.29	Professional	TC	$347.90	$364.29	$364.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $278.58 / $303.91 / $354.56	Professional		$278.58	$303.91	$354.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.20 / $71.12 / $82.98	Professional	26	$65.20	$71.12	$82.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $213.40 / $232.80 / $246.38	Professional	TC	$213.40	$232.80	$246.38
United Facility/Professional Professional Modifier Low / Median / High Price $140.91 / $341.90 / $419.66	Professional		$140.91	$341.90	$419.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.62 / $87.90 / $484.50	Professional	26	$64.62	$87.90	$484.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.41 / $261.89 / $318.68	Professional	TC	$102.41	$261.89	$318.68
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $313.83 / $443.78 / $701.86	Professional		$313.83	$443.78	$701.86
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $60.07 / $91.43 / $153.41	Professional	26	$60.07	$91.43	$153.41
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $240.56 / $335.40 / $572.28	Professional	TC	$240.56	$335.40	$572.28