Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $157.19 / $178.16 / $209.60	Facility	26	$157.19	$178.16	$209.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.11 / $296.83 / $678.21	Professional		$193.11	$296.83	$678.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.20 / $146.87 / $263.76	Professional	26	$102.20	$146.87	$263.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.91 / $145.68 / $259.27	Professional	TC	$90.91	$145.68	$259.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.84 / $314.38 / $416.30	Professional		$225.84	$314.38	$416.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.37 / $169.74 / $209.60	Professional	26	$117.37	$169.74	$209.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.47 / $144.63 / $206.70	Professional	TC	$108.47	$144.63	$206.70
HMSA Facility/Professional Professional Modifier Low / Median / High Price $175.14 / $196.63 / $400.27	Professional		$175.14	$196.63	$400.27
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $195.80 / $205.03 / $326.72	Professional	26	$195.80	$205.03	$326.72
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $186.45 / $195.24 / $218.48	Professional	TC	$186.45	$195.24	$218.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $310.48 / $370.04 / $431.72	Professional		$310.48	$370.04	$431.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $159.91 / $186.31 / $217.36	Professional	26	$159.91	$186.31	$217.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.69 / $183.73 / $191.39	Professional	TC	$157.69	$183.73	$191.39
United Facility/Professional Professional Modifier Low / Median / High Price $392.68 / $416.30 / $481.83	Professional		$392.68	$416.30	$481.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $207.43 / $209.60 / $245.37	Professional	26	$207.43	$209.60	$245.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.25 / $206.70 / $236.46	Professional	TC	$185.25	$206.70	$236.46
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $380.75 / $472.19 / $783.14	Professional		$380.75	$472.19	$783.14
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $191.88 / $240.46 / $384.99	Professional	26	$191.88	$240.46	$384.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $187.53 / $231.73 / $398.15	Professional	TC	$187.53	$231.73	$398.15