Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $63.10 / $74.13	Facility	26	$56.23	$63.10	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $245.47	Professional		$114.82	$147.91	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $47.86 / $125.89	Professional	26	$37.15	$47.86	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $97.72 / $169.82	Professional	TC	$79.43	$97.72	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $380.19	Professional		$245.47	$257.04	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $74.13 / $123.03	Professional	26	$67.61	$74.13	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $181.97 / $257.04	Professional	TC	$177.83	$181.97	$257.04
HMSA Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $323.59	Professional		$257.04	$316.23	$323.59
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $77.62 / $79.43	Professional	26	$75.86	$77.62	$79.43
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $229.09 / $239.88	Professional	TC	$229.09	$229.09	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $263.03	Professional		$208.93	$223.87	$263.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $66.07 / $77.62	Professional	26	$60.26	$66.07	$77.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $158.49 / $165.96	Professional	TC	$134.90	$158.49	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $275.42 / $302.00	Professional		$131.83	$275.42	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $75.86 / $93.33	Professional	26	$42.66	$75.86	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $194.98 / $208.93	Professional	TC	$89.13	$194.98	$208.93
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $467.74	Professional		$208.93	$288.40	$467.74
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $141.25	Professional	26	$63.10	$83.18	$141.25
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $338.84	Professional	TC	$144.54	$204.17	$338.84