Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.27 / $62.64 / $73.70	Facility	26	$55.27	$62.64	$73.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.13 / $384.26 / $572.33	Professional		$237.13	$384.26	$572.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.40 / $53.78 / $84.25	Professional	26	$38.40	$53.78	$84.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $198.72 / $328.80 / $488.08	Professional	TC	$198.72	$328.80	$488.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.58 / $412.58 / $568.64	Professional		$412.58	$412.58	$568.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.05 / $67.05 / $80.45	Professional	26	$67.05	$67.05	$80.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $345.53 / $345.53 / $488.19	Professional	TC	$345.53	$345.53	$488.19
HMSA Facility/Professional Professional Modifier Low / Median / High Price $69.44 / $511.12 / $593.59	Professional		$69.44	$511.12	$593.59
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $71.89 / $75.28 / $77.16	Professional	26	$71.89	$75.28	$77.16
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $414.43 / $433.96 / $433.96	Professional	TC	$414.43	$433.96	$433.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $376.87 / $411.13 / $428.26	Professional		$376.87	$411.13	$428.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.05 / $65.51 / $68.23	Professional	26	$60.05	$65.51	$68.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $316.82 / $345.62 / $360.03	Professional	TC	$316.82	$345.62	$360.03
United Facility/Professional Professional Modifier Low / Median / High Price $462.52 / $523.73 / $615.05	Professional		$462.52	$523.73	$615.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.70 / $81.78 / $92.49	Professional	26	$73.70	$81.78	$92.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $388.83 / $441.95 / $522.57	Professional	TC	$388.83	$441.95	$522.57
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $424.64 / $602.76 / $980.42	Professional		$424.64	$602.76	$980.42
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $67.48 / $90.64 / $150.63	Professional	26	$67.48	$90.64	$150.63
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $357.14 / $512.12 / $834.21	Professional	TC	$357.14	$512.12	$834.21