Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.95 / $123.47 / $145.26	Facility	26	$108.95	$123.47	$145.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $475.00 / $537.12 / $733.88	Professional		$475.00	$537.12	$733.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.11 / $150.18 / $166.19	Professional	26	$111.11	$150.18	$166.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $335.00 / $348.53 / $449.42	Professional	TC	$335.00	$348.53	$449.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.62 / $124.62 / $124.62	Facility	26	$124.62	$124.62	$124.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $427.64 / $444.62 / $559.16	Professional		$427.64	$444.62	$559.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $118.08 / $131.35 / $158.13	Professional	26	$118.08	$131.35	$158.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $304.27 / $313.26 / $397.76	Professional	TC	$304.27	$313.26	$397.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $128.34 / $1,314.67 / $1,681.50	Professional		$128.34	$1,314.67	$1,681.50
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $140.69 / $147.32 / $150.99	Professional	26	$140.69	$147.32	$150.99
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $1,173.98 / $1,229.30 / $1,229.30	Professional	TC	$1,173.98	$1,229.30	$1,229.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $410.05 / $447.32 / $521.88	Professional		$410.05	$447.32	$521.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $118.36 / $129.12 / $150.63	Professional	26	$118.36	$129.12	$150.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $291.69 / $318.20 / $336.77	Professional	TC	$291.69	$318.20	$336.77
United Facility/Professional Professional Modifier Low / Median / High Price $87.90 / $503.24 / $1,306.98	Professional		$87.90	$503.24	$1,306.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.48 / $145.26 / $181.73	Professional	26	$66.48	$145.26	$181.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.15 / $357.98 / $692.65	Professional	TC	$151.15	$357.98	$692.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $478.30 / $658.85 / $1,047.70	Professional		$478.30	$658.85	$1,047.70
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $133.06 / $178.09 / $276.30	Professional	26	$133.06	$178.09	$276.30
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $328.81 / $480.75 / $766.37	Professional	TC	$328.81	$480.75	$766.37