Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.67 / $77.81 / $91.56	Facility	26	$68.67	$77.81	$91.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $475.00 / $522.50	Professional		$250.00	$475.00	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.36 / $104.79 / $154.00	Professional	26	$74.36	$104.79	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $209.22 / $335.00 / $368.50	Professional	TC	$209.22	$335.00	$368.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.09 / $79.09 / $79.09	Facility	26	$79.09	$79.09	$79.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.70 / $470.51 / $599.99	Professional		$281.70	$470.51	$599.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.18 / $80.97 / $99.93	Professional	26	$72.18	$80.97	$99.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $183.88 / $403.31 / $500.06	Professional	TC	$183.88	$403.31	$500.06
HMSA Facility/Professional Professional Modifier Low / Median / High Price $87.78 / $655.77 / $809.13	Professional		$87.78	$655.77	$809.13
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $90.86 / $95.14 / $97.53	Professional	26	$90.86	$95.14	$97.53
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $564.91 / $591.53 / $591.53	Professional	TC	$564.91	$591.53	$591.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $233.63 / $254.87 / $297.35	Professional		$233.63	$254.87	$297.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.59 / $81.38 / $94.95	Professional	26	$74.59	$81.38	$94.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $159.03 / $173.48 / $183.60	Professional	TC	$159.03	$173.48	$183.60
United Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $286.73 / $490.18	Professional		$123.63	$286.73	$490.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.44 / $91.56 / $115.74	Professional	26	$42.44	$91.56	$115.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.19 / $195.17 / $380.83	Professional	TC	$81.19	$195.17	$380.83
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $263.13 / $590.34 / $869.78	Professional		$263.13	$590.34	$869.78
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $68.98 / $107.51 / $176.32	Professional	26	$68.98	$107.51	$176.32
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $179.27 / $448.67 / $732.05	Professional	TC	$179.27	$448.67	$732.05