Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $72.44 / $85.11	Facility	26	$64.57	$72.44	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $295.12	Professional		$104.71	$144.54	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $64.57 / $131.83	Professional	26	$42.66	$64.57	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $70.79 / $186.21	Professional	TC	$48.98	$70.79	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $288.40 / $707.95	Professional		$154.88	$288.40	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $70.79 / $114.82	Professional	26	$51.29	$70.79	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $204.17 / $645.65	Professional	TC	$83.18	$204.17	$645.65
HMSA Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $831.76 / $912.01	Professional		$602.56	$831.76	$912.01
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $91.20	Professional	26	$85.11	$87.10	$91.20
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $645.65 / $676.08	Professional	TC	$645.65	$645.65	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $158.49 / $186.21	Professional		$144.54	$158.49	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $77.62 / $91.20	Professional	26	$70.79	$77.62	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $81.28 / $93.33	Professional	TC	$74.13	$81.28	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $489.78	Professional		$147.91	$208.93	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $83.18 / $134.90	Professional	26	$72.44	$83.18	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $120.23 / $416.87	Professional	TC	$70.79	$120.23	$416.87
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $794.33	Professional		$165.96	$229.09	$794.33
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $93.33 / $117.49	Professional	26	$61.66	$93.33	$117.49
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $162.18 / $724.44	Professional	TC	$85.11	$162.18	$724.44