Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.66 / $77.81 / $91.54	Facility	26	$68.66	$77.81	$91.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.21 / $163.04 / $212.42	Professional		$147.21	$163.04	$212.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.60 / $69.20 / $274.33	Professional	26	$49.60	$69.20	$274.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.59 / $110.49 / $121.53	Professional	TC	$97.59	$110.49	$121.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.31 / $79.31 / $79.31	Facility	26	$79.31	$79.31	$79.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.93 / $192.13 / $405.03	Professional		$139.93	$192.13	$405.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.96 / $67.30 / $91.54	Professional	26	$58.96	$67.30	$91.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.54 / $118.04 / $340.11	Professional	TC	$77.54	$118.04	$340.11
HMSA Facility/Professional Professional Modifier Low / Median / High Price $81.81 / $508.59 / $599.99	Professional		$81.81	$508.59	$599.99
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $89.69 / $93.92 / $96.26	Professional	26	$89.69	$93.92	$96.26
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $418.90 / $438.64 / $439.98	Professional	TC	$418.90	$438.64	$439.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.71 / $157.86 / $184.17	Professional		$144.71	$157.86	$184.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.59 / $81.37 / $94.93	Professional	26	$74.59	$81.37	$94.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.11 / $76.48 / $89.24	Professional	TC	$70.11	$76.48	$89.24
United Facility/Professional Professional Modifier Low / Median / High Price $150.94 / $177.59 / $249.92	Professional		$150.94	$177.59	$249.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.43 / $91.54 / $116.42	Professional	26	$72.43	$91.54	$116.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.55 / $86.05 / $133.50	Professional	TC	$68.55	$86.05	$133.50
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $162.87 / $234.58 / $506.85	Professional		$162.87	$234.58	$506.85
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $61.08 / $100.78 / $137.66	Professional	26	$61.08	$100.78	$137.66
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $93.70 / $126.52 / $410.23	Professional	TC	$93.70	$126.52	$410.23