Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $56.23 / $66.07	Facility	26	$48.98	$56.23	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $467.74	Professional		$223.87	$275.42	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $41.69 / $67.61	Professional	26	$33.11	$41.69	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $239.88 / $407.38	Professional	TC	$190.55	$239.88	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $741.31	Professional		$363.08	$436.52	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $112.20	Professional	26	$58.88	$66.07	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $371.54 / $616.60	Professional	TC	$309.03	$371.54	$616.60
HMSA Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $489.78 / $537.03	Professional		$436.52	$489.78	$537.03
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $66.07 / $67.61	Professional	26	$64.57	$66.07	$67.61
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $380.19 / $398.11	Professional	TC	$380.19	$380.19	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $389.05 / $457.09	Professional		$354.81	$389.05	$457.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $58.88 / $69.18	Professional	26	$53.70	$58.88	$69.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $331.13 / $346.74	Professional	TC	$275.42	$331.13	$346.74
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $467.74 / $575.44	Professional		$239.88	$467.74	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $72.44 / $83.18	Professional	26	$37.15	$72.44	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $398.11 / $501.19	Professional	TC	$204.17	$398.11	$501.19
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $489.78 / $912.01	Professional		$346.74	$489.78	$912.01
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $125.89	Professional	26	$52.48	$72.44	$125.89
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $416.87 / $794.33	Professional	TC	$281.84	$416.87	$794.33