Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.76 / $41.67 / $49.02	Facility	26	$36.76	$41.67	$49.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.55 / $282.76 / $544.33	Professional		$223.55	$282.76	$544.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.17 / $49.02 / $74.30	Professional	26	$33.17	$49.02	$74.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $197.81 / $247.61 / $488.29	Professional	TC	$197.81	$247.61	$488.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.47 / $208.47 / $468.43	Professional		$208.47	$208.47	$468.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.34 / $43.34 / $53.82	Professional	26	$43.34	$43.34	$53.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.13 / $165.13 / $414.62	Professional	TC	$165.13	$165.13	$414.62
HMSA Facility/Professional Professional Modifier Low / Median / High Price $58.81 / $336.46 / $467.26	Professional		$58.81	$336.46	$467.26
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $48.62 / $50.91 / $52.19	Professional	26	$48.62	$50.91	$52.19
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $397.61 / $416.35 / $478.81	Professional	TC	$397.61	$416.35	$478.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.97 / $389.42 / $405.65	Professional		$356.97	$389.42	$405.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.94 / $43.57 / $45.39	Professional	26	$39.94	$43.57	$45.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $317.02 / $345.84 / $360.25	Professional	TC	$317.02	$345.84	$360.25
United Facility/Professional Professional Modifier Low / Median / High Price $331.09 / $438.10 / $581.51	Professional		$331.09	$438.10	$581.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.78 / $49.02 / $61.41	Professional	26	$48.78	$49.02	$61.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $282.31 / $389.07 / $520.10	Professional	TC	$282.31	$389.07	$520.10
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $294.95 / $479.15 / $921.63	Professional		$294.95	$479.15	$921.63
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $42.16 / $55.58 / $93.13	Professional	26	$42.16	$55.58	$93.13
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $238.10 / $423.65 / $828.51	Professional	TC	$238.10	$423.65	$828.51