Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.31 / $53.62 / $63.09	Facility	26	$47.31	$53.62	$63.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.85 / $322.95 / $567.41	Professional		$232.85	$322.95	$567.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.77 / $48.27 / $72.19	Professional	26	$32.77	$48.27	$72.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.08 / $274.68 / $495.22	Professional	TC	$200.08	$274.68	$495.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.69 / $247.69 / $565.26	Professional		$247.69	$247.69	$565.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.70 / $56.70 / $68.89	Professional	26	$56.70	$56.70	$68.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.99 / $190.99 / $496.36	Professional	TC	$190.99	$190.99	$496.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $61.77 / $374.14 / $489.87	Professional		$61.77	$374.14	$489.87
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $63.94 / $66.95 / $68.63	Professional	26	$63.94	$66.95	$68.63
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $403.89 / $422.92 / $486.37	Professional	TC	$403.89	$422.92	$486.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $372.92 / $406.82 / $423.78	Professional		$372.92	$406.82	$423.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $51.40 / $56.08 / $58.41	Professional	26	$51.40	$56.08	$58.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $321.52 / $350.75 / $365.36	Professional	TC	$321.52	$350.75	$365.36
United Facility/Professional Professional Modifier Low / Median / High Price $396.62 / $457.68 / $603.39	Professional		$396.62	$457.68	$603.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.09 / $63.56 / $79.59	Professional	26	$63.09	$63.56	$79.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.27 / $394.59 / $523.79	Professional	TC	$229.27	$394.59	$523.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $346.30 / $514.78 / $946.91	Professional		$346.30	$514.78	$946.91
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $53.74 / $72.41 / $120.29	Professional	26	$53.74	$72.41	$120.29
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $275.69 / $445.73 / $826.60	Professional	TC	$275.69	$445.73	$826.60