Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.56 / $83.42 / $1,308.15	Facility		$62.56	$83.42	$1,308.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.02 / $34.02 / $40.03	Facility	26	$30.02	$34.02	$40.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.41 / $179.53 / $910.00	Professional		$64.41	$179.53	$910.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.01 / $41.22 / $124.00	Professional	26	$29.01	$41.22	$124.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.00 / $150.53 / $187.42	Professional	TC	$28.00	$150.53	$187.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.84 / $65.84 / $65.84	Facility		$65.84	$65.84	$65.84
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.51 / $34.51 / $34.51	Facility	26	$34.51	$34.51	$34.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.69 / $83.42 / $231.20	Professional		$45.69	$83.42	$231.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $37.86 / $71.16	Professional	26	$24.24	$37.86	$71.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $43.39 / $187.83	Professional	TC	$21.45	$43.39	$187.83
HMSA Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $224.81 / $245.37	Professional		$39.40	$224.81	$245.37
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $42.19 / $44.18 / $45.29	Professional	26	$42.19	$44.18	$45.29
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $192.14 / $201.19 / $201.19	Professional	TC	$192.14	$201.19	$201.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.97 / $74.15 / $86.51	Professional		$67.97	$74.15	$86.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.61 / $35.58 / $41.51	Professional	26	$32.61	$35.58	$41.51
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.35 / $38.57 / $45.00	Professional	TC	$35.35	$38.57	$45.00
United Facility/Professional Professional Modifier Low / Median / High Price $62.56 / $83.42 / $94.25	Professional		$62.56	$83.42	$94.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.02 / $40.03 / $49.92	Professional	26	$30.02	$40.03	$49.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.17 / $43.39 / $48.47	Professional	TC	$15.17	$43.39	$48.47
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.83 / $137.37 / $341.97	Professional		$71.83	$137.37	$341.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.01 / $46.85 / $77.92	Professional	26	$32.01	$46.85	$77.92
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $38.42 / $85.46 / $294.25	Professional	TC	$38.42	$85.46	$294.25