Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $232.05 / $263.00 / $309.41	Facility	26	$232.05	$263.00	$309.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $427.44 / $517.91 / $1,248.39	Professional		$427.44	$517.91	$1,248.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $188.34 / $314.12 / $810.02	Professional	26	$188.34	$314.12	$810.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.11 / $367.92 / $466.86	Professional	TC	$239.11	$367.92	$466.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $410.51 / $522.32 / $681.66	Professional		$410.51	$522.32	$681.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $172.64 / $252.90 / $309.41	Professional	26	$172.64	$252.90	$309.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $237.87 / $269.42 / $372.25	Professional	TC	$237.87	$269.42	$372.25
HMSA Facility/Professional Professional Modifier Low / Median / High Price $273.38 / $490.68 / $662.47	Professional		$273.38	$490.68	$662.47
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $290.08 / $303.75 / $311.33	Professional	26	$290.08	$303.75	$311.33
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $342.58 / $358.72 / $358.72	Professional	TC	$342.58	$358.72	$358.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $520.08 / $605.91 / $706.90	Professional		$520.08	$605.91	$706.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $236.07 / $275.02 / $320.87	Professional	26	$236.07	$275.02	$320.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $284.01 / $330.89 / $344.68	Professional	TC	$284.01	$330.89	$344.68
United Facility/Professional Professional Modifier Low / Median / High Price $653.32 / $681.66 / $815.12	Professional		$653.32	$681.66	$815.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $309.41 / $309.92 / $362.72	Professional	26	$309.41	$309.92	$362.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $343.40 / $372.25 / $452.40	Professional	TC	$343.40	$372.25	$452.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $575.92 / $738.37 / $1,328.02	Professional		$575.92	$738.37	$1,328.02
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $231.32 / $336.10 / $543.10	Professional	26	$231.32	$336.10	$543.10
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $334.65 / $403.96 / $728.68	Professional	TC	$334.65	$403.96	$728.68