Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.14 / $26.22 / $30.85	Facility	26	$23.14	$26.22	$30.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $160.76 / $258.89 / $394.16	Professional		$160.76	$258.89	$394.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.04 / $22.60 / $35.29	Professional	26	$16.04	$22.60	$35.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.72 / $235.56 / $358.87	Professional	TC	$144.72	$235.56	$358.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.79 / $275.79 / $383.64	Professional		$275.79	$275.79	$383.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.20 / $28.20 / $33.86	Professional	26	$28.20	$28.20	$33.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $247.59 / $247.59 / $349.77	Professional	TC	$247.59	$247.59	$349.77
HMSA Facility/Professional Professional Modifier Low / Median / High Price $30.01 / $187.41 / $337.90	Professional		$30.01	$187.41	$337.90
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $31.06 / $32.52 / $33.34	Professional	26	$31.06	$32.52	$33.34
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $291.64 / $305.38 / $351.20	Professional	TC	$291.64	$305.38	$351.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $258.14 / $281.62 / $293.35	Professional		$258.14	$281.62	$293.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $27.42 / $28.56	Professional	26	$25.14	$27.42	$28.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $233.01 / $254.20 / $264.79	Professional	TC	$233.01	$254.20	$264.79
United Facility/Professional Professional Modifier Low / Median / High Price $316.82 / $351.29 / $419.21	Professional		$316.82	$351.29	$419.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.84 / $30.85 / $38.46	Professional	26	$17.84	$30.85	$38.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $285.97 / $316.80 / $380.75	Professional	TC	$285.97	$316.80	$380.75
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $308.66 / $410.48 / $663.16	Professional		$308.66	$410.48	$663.16
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $29.05 / $37.79 / $59.09	Professional	26	$29.05	$37.79	$59.09
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $279.61 / $371.93 / $604.07	Professional	TC	$279.61	$371.93	$604.07