Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.45 / $92.32 / $108.61	Facility	26	$81.45	$92.32	$108.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $494.18 / $549.21	Professional		$475.00	$494.18	$549.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $124.36 / $140.00 / $154.00	Professional	26	$124.36	$140.00	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $424.84	Professional	TC	$335.00	$348.53	$424.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.41 / $93.41 / $93.41	Facility	26	$93.41	$93.41	$93.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $436.86 / $606.36 / $797.43	Professional		$436.86	$606.36	$797.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.64 / $96.23 / $118.79	Professional	26	$79.64	$96.23	$118.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $321.14 / $527.00 / $700.05	Professional	TC	$321.14	$527.00	$700.05
HMSA Facility/Professional Professional Modifier Low / Median / High Price $97.74 / $783.89 / $969.31	Professional		$97.74	$783.89	$969.31
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $107.14 / $112.19 / $114.99	Professional	26	$107.14	$112.19	$114.99
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $676.75 / $708.64 / $708.64	Professional	TC	$676.75	$708.64	$708.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $364.24 / $397.36 / $463.58	Professional		$364.24	$397.36	$463.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.50 / $96.54 / $112.63	Professional	26	$88.50	$96.54	$112.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $275.74 / $300.80 / $318.35	Professional	TC	$275.74	$300.80	$318.35
United Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $447.03 / $667.44	Professional		$192.00	$447.03	$667.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.19 / $108.61 / $136.97	Professional	26	$50.19	$108.61	$136.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.81 / $338.40 / $548.75	Professional	TC	$141.81	$338.40	$548.75
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $410.32 / $707.11 / $1,010.61	Professional		$410.32	$707.11	$1,010.61
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $81.78 / $121.86 / $209.21	Professional	26	$81.78	$121.86	$209.21
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $310.83 / $614.64 / $853.16	Professional	TC	$310.83	$614.64	$853.16