Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.93 / $92.86 / $109.24	Facility	26	$81.93	$92.86	$109.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.62 / $316.23 / $407.51	Professional		$264.62	$316.23	$407.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.00 / $116.45 / $276.22	Professional	26	$73.00	$116.45	$276.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $191.62 / $235.18 / $282.39	Professional	TC	$191.62	$235.18	$282.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.84 / $93.84 / $93.84	Facility	26	$93.84	$93.84	$93.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.24 / $286.25 / $371.40	Professional		$274.24	$286.25	$371.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.96 / $96.27 / $119.17	Professional	26	$86.96	$96.27	$119.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.99 / $195.38 / $250.02	Professional	TC	$189.99	$195.38	$250.02
HMSA Facility/Professional Professional Modifier Low / Median / High Price $97.46 / $322.24 / $366.06	Professional		$97.46	$322.24	$366.06
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $106.82 / $111.85 / $114.66	Professional	26	$106.82	$111.85	$114.66
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $224.98 / $249.08 / $260.82	Professional	TC	$224.98	$249.08	$260.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $272.36 / $297.12 / $346.64	Professional		$272.36	$297.12	$346.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $89.01 / $97.10 / $113.29	Professional	26	$89.01	$97.10	$113.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $183.35 / $200.02 / $211.68	Professional	TC	$183.35	$200.02	$211.68
United Facility/Professional Professional Modifier Low / Median / High Price $142.88 / $334.26 / $418.36	Professional		$142.88	$334.26	$418.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.37 / $109.24 / $137.12	Professional	26	$52.37	$109.24	$137.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.51 / $225.02 / $294.27	Professional	TC	$90.51	$225.02	$294.27
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $317.42 / $404.41 / $691.15	Professional		$317.42	$404.41	$691.15
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $91.10 / $132.54 / $209.39	Professional	26	$91.10	$132.54	$209.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $214.31 / $283.58 / $466.64	Professional	TC	$214.31	$283.58	$466.64