Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.25 / $51.28 / $60.33	Facility	26	$45.25	$51.28	$60.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.65 / $275.07 / $372.39	Professional		$153.65	$275.07	$372.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.41 / $47.65 / $68.98	Professional	26	$31.41	$47.65	$68.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $122.24 / $227.42 / $303.39	Professional	TC	$122.24	$227.42	$303.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.50 / $275.50 / $373.39	Professional		$275.50	$275.50	$373.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $55.03 / $55.03 / $66.13	Professional	26	$55.03	$55.03	$66.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.47 / $220.47 / $307.26	Professional	TC	$220.47	$220.47	$307.26
HMSA Facility/Professional Professional Modifier Low / Median / High Price $59.63 / $359.34 / $400.89	Professional		$59.63	$359.34	$400.89
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $61.73 / $64.64 / $66.26	Professional	26	$61.73	$64.64	$66.26
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $279.89 / $293.08 / $293.08	Professional	TC	$279.89	$293.08	$293.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $246.19 / $268.57 / $279.76	Professional		$246.19	$268.57	$279.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $49.16 / $53.63 / $55.86	Professional	26	$49.16	$53.63	$55.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $197.03 / $214.94 / $223.90	Professional	TC	$197.03	$214.94	$223.90
United Facility/Professional Professional Modifier Low / Median / High Price $302.14 / $351.79 / $393.68	Professional		$302.14	$351.79	$393.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.33 / $62.58 / $76.17	Professional	26	$60.33	$62.58	$76.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $241.81 / $289.20 / $317.51	Professional	TC	$241.81	$289.20	$317.51
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $277.38 / $368.25 / $621.41	Professional		$277.38	$368.25	$621.41
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $52.46 / $70.51 / $116.04	Professional	26	$52.46	$70.51	$116.04
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $222.11 / $296.75 / $505.38	Professional	TC	$222.11	$296.75	$505.38