Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.33 / $166.79 / $694.34	Facility		$72.33	$166.79	$694.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.17 / $43.26 / $50.90	Facility	26	$38.17	$43.26	$50.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $122.62 / $146.41 / $768.00	Professional		$122.62	$146.41	$768.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.68 / $39.63 / $86.05	Professional	26	$7.68	$39.63	$86.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.85 / $91.86 / $145.38	Professional	TC	$85.85	$91.86	$145.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.11 / $130.11 / $130.11	Facility		$130.11	$130.11	$130.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.62 / $43.62 / $43.62	Facility	26	$43.62	$43.62	$43.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.26 / $154.22 / $299.36	Professional		$90.26	$154.22	$299.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.63 / $48.18 / $86.68	Professional	26	$30.63	$48.18	$86.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.63 / $107.13 / $212.68	Professional	TC	$59.63	$107.13	$212.68
HMSA Facility/Professional Professional Modifier Low / Median / High Price $47.42 / $145.93 / $184.45	Professional		$47.42	$145.93	$184.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $50.78 / $53.17 / $54.50	Professional	26	$50.78	$53.17	$54.50
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $115.13 / $120.55 / $138.63	Professional	TC	$115.13	$120.55	$138.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $135.91 / $148.26 / $172.97	Professional		$135.91	$148.26	$172.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.47 / $45.24 / $52.78	Professional	26	$41.47	$45.24	$52.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.44 / $103.02 / $120.19	Professional	TC	$94.44	$103.02	$120.19
United Facility/Professional Professional Modifier Low / Median / High Price $125.09 / $166.79 / $207.23	Professional		$125.09	$166.79	$207.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.17 / $50.90 / $64.44	Professional	26	$38.17	$50.90	$64.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $115.90 / $142.79	Professional	TC	$83.37	$115.90	$142.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $136.03 / $186.33 / $319.24	Professional		$136.03	$186.33	$319.24
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $38.35 / $58.73 / $97.64	Professional	26	$38.35	$58.73	$97.64
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $90.77 / $130.52 / $221.61	Professional	TC	$90.77	$130.52	$221.61