Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.55 / $95.83 / $112.74	Facility	26	$84.55	$95.83	$112.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $462.82 / $594.37 / $2,247.35	Professional		$462.82	$594.37	$2,247.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.87 / $88.31 / $352.91	Professional	26	$71.87	$88.31	$352.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $398.59 / $508.06 / $1,040.24	Professional	TC	$398.59	$508.06	$1,040.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.81 / $429.39 / $650.85	Professional		$346.81	$429.39	$650.85
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.69 / $86.45 / $112.74	Professional	26	$62.69	$86.45	$112.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $260.37 / $355.29 / $538.10	Professional	TC	$260.37	$355.29	$538.10
HMSA Facility/Professional Professional Modifier Low / Median / High Price $119.95 / $592.08 / $727.12	Professional		$119.95	$592.08	$727.12
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $106.15 / $111.15 / $113.93	Professional	26	$106.15	$111.15	$113.93
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $537.66 / $563.01 / $647.46	Professional	TC	$537.66	$563.01	$647.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $496.57 / $578.53 / $674.95	Professional		$496.57	$578.53	$674.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $86.02 / $100.21 / $116.91	Professional	26	$86.02	$100.21	$116.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $410.55 / $478.31 / $498.24	Professional	TC	$410.55	$478.31	$498.24
United Facility/Professional Professional Modifier Low / Median / High Price $592.23 / $650.85 / $858.15	Professional		$592.23	$650.85	$858.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $96.08 / $132.87 / $132.87	Professional	26	$96.08	$132.87	$132.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $496.15 / $538.10 / $725.28	Professional	TC	$496.15	$538.10	$725.28
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $486.29 / $728.44 / $1,360.94	Professional		$486.29	$728.44	$1,360.94
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $84.30 / $122.47 / $198.33	Professional	26	$84.30	$122.47	$198.33
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $375.42 / $606.40 / $1,133.51	Professional	TC	$375.42	$606.40	$1,133.51