Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.03 / $53.30 / $62.71	Facility	26	$47.03	$53.30	$62.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.33 / $237.19 / $282.18	Professional		$154.33	$237.19	$282.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.82 / $49.32 / $156.41	Professional	26	$44.82	$49.32	$156.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $111.43 / $132.85 / $210.32	Professional	TC	$111.43	$132.85	$210.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.23 / $195.74 / $251.17	Professional		$186.23	$195.74	$251.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.67 / $55.63 / $66.81	Professional	26	$52.67	$55.63	$66.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.60 / $142.44 / $184.53	Professional	TC	$130.60	$142.44	$184.53
HMSA Facility/Professional Professional Modifier Low / Median / High Price $57.78 / $183.25 / $246.68	Professional		$57.78	$183.25	$246.68
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $61.44 / $64.34 / $66.41	Professional	26	$61.44	$64.34	$66.41
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $160.97 / $183.26 / $191.90	Professional	TC	$160.97	$183.26	$191.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $187.64 / $204.70 / $238.81	Professional		$187.64	$204.70	$238.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $55.74 / $65.03	Professional	26	$51.10	$55.74	$65.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $136.54 / $148.96 / $157.65	Professional	TC	$136.54	$148.96	$157.65
United Facility/Professional Professional Modifier Low / Median / High Price $92.63 / $230.28 / $285.69	Professional		$92.63	$230.28	$285.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.97 / $62.71 / $79.11	Professional	26	$28.97	$62.71	$79.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.66 / $167.58 / $206.58	Professional	TC	$63.66	$167.58	$206.58
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $215.75 / $280.39 / $440.38	Professional		$215.75	$280.39	$440.38
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $59.05 / $76.47 / $117.25	Professional	26	$59.05	$76.47	$117.25
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $156.69 / $206.11 / $323.13	Professional	TC	$156.69	$206.11	$323.13