Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $44.67 / $52.48	Facility	26	$39.81	$44.67	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $426.58	Professional		$169.82	$229.09	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $91.20	Professional	26	$26.92	$40.74	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $194.98 / $371.54	Professional	TC	$144.54	$194.98	$371.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $389.05 / $660.69	Professional		$218.78	$389.05	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $52.48 / $89.13	Professional	26	$47.86	$52.48	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $338.84 / $575.44	Professional	TC	$169.82	$338.84	$575.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $467.74 / $478.63	Professional		$389.05	$467.74	$478.63
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $56.23	Professional	26	$53.70	$54.95	$56.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $363.08 / $363.08	Professional	TC	$346.74	$363.08	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $346.74 / $407.38	Professional		$316.23	$346.74	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $47.86 / $54.95	Professional	26	$43.65	$47.86	$54.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $302.00 / $316.23	Professional	TC	$251.19	$302.00	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $309.03 / $524.81	Professional		$194.98	$309.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $53.70 / $67.61	Professional	26	$30.90	$53.70	$67.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $257.04 / $457.09	Professional	TC	$162.18	$257.04	$457.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $724.44	Professional		$295.12	$436.52	$724.44
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $89.13	Professional	26	$44.67	$58.88	$89.13
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $371.54 / $630.96	Professional	TC	$245.47	$371.54	$630.96