Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $105.80 / $119.90 / $141.06	Facility	26	$105.80	$119.90	$141.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.08 / $343.67 / $627.50	Professional		$232.08	$343.67	$627.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.09 / $100.03 / $163.77	Professional	26	$68.09	$100.03	$163.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $163.98 / $241.02 / $463.70	Professional	TC	$163.98	$241.02	$463.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.50 / $354.03 / $510.56	Professional		$258.50	$354.03	$510.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.41 / $115.04 / $141.06	Professional	26	$79.41	$115.04	$141.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.10 / $238.99 / $369.51	Professional	TC	$179.10	$238.99	$369.51
HMSA Facility/Professional Professional Modifier Low / Median / High Price $128.33 / $425.34 / $499.75	Professional		$128.33	$425.34	$499.75
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $132.24 / $138.47 / $147.51	Professional	26	$132.24	$138.47	$147.51
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $345.02 / $361.28 / $375.50	Professional	TC	$345.02	$361.28	$375.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.54 / $453.83 / $529.47	Professional		$389.54	$453.83	$529.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $107.62 / $125.39 / $146.29	Professional	26	$107.62	$125.39	$146.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $281.92 / $328.45 / $342.14	Professional	TC	$281.92	$328.45	$342.14
United Facility/Professional Professional Modifier Low / Median / High Price $446.39 / $510.56 / $570.88	Professional		$446.39	$510.56	$570.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $140.41 / $141.06 / $165.35	Professional	26	$140.41	$141.06	$165.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $305.97 / $369.51 / $405.53	Professional	TC	$305.97	$369.51	$405.53
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $468.65 / $559.63 / $890.58	Professional		$468.65	$559.63	$890.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $129.25 / $153.69 / $259.48	Professional	26	$129.25	$153.69	$259.48
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $339.40 / $407.57 / $631.10	Professional	TC	$339.40	$407.57	$631.10