Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.88 / $47.46 / $55.84	Facility	26	$41.88	$47.46	$55.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.97 / $436.79 / $718.78	Professional		$295.97	$436.79	$718.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $41.51 / $63.87	Professional	26	$29.14	$41.51	$63.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $266.83 / $399.06 / $654.91	Professional	TC	$266.83	$399.06	$654.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $511.25 / $511.25 / $836.43	Professional		$511.25	$511.25	$836.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.15 / $50.15 / $63.44	Professional	26	$50.15	$50.15	$63.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $461.10 / $461.10 / $772.99	Professional	TC	$461.10	$461.10	$772.99
HMSA Facility/Professional Professional Modifier Low / Median / High Price $61.55 / $639.73 / $786.30	Professional		$61.55	$639.73	$786.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $54.47 / $57.04 / $58.46	Professional	26	$54.47	$57.04	$58.46
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $548.98 / $574.85 / $574.85	Professional	TC	$548.98	$574.85	$574.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $470.65 / $513.42 / $534.83	Professional		$470.65	$513.42	$534.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.50 / $49.63 / $51.70	Professional	26	$45.50	$49.63	$51.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $425.15 / $463.80 / $483.13	Professional	TC	$425.15	$463.80	$483.13
United Facility/Professional Professional Modifier Low / Median / High Price $577.61 / $650.86 / $774.95	Professional		$577.61	$650.86	$774.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $55.84 / $61.10 / $70.58	Professional	26	$55.84	$61.10	$70.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $304.93 / $521.78 / $704.37	Professional	TC	$304.93	$521.78	$704.37
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $530.40 / $669.83 / $1,072.61	Professional		$530.40	$669.83	$1,072.61
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.86 / $62.34 / $93.48	Professional	26	$40.86	$62.34	$93.48
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $479.26 / $607.51 / $979.14	Professional	TC	$479.26	$607.51	$979.14