Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $55.60 / $63.01 / $74.13	Facility	26	$55.60	$63.01	$74.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.75 / $179.96 / $310.58	Professional		$119.75	$179.96	$310.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.63 / $57.27 / $183.03	Professional	26	$38.63	$57.27	$183.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.12 / $125.34 / $225.86	Professional	TC	$81.12	$125.34	$225.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.09 / $246.09 / $270.14	Professional		$246.09	$246.09	$270.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.59 / $67.59 / $80.59	Professional	26	$67.59	$67.59	$80.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $178.50 / $178.50 / $189.55	Professional	TC	$178.50	$178.50	$189.55
HMSA Facility/Professional Professional Modifier Low / Median / High Price $92.02 / $304.83 / $324.91	Professional		$92.02	$304.83	$324.91
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $76.08 / $79.66 / $81.65	Professional	26	$76.08	$79.66	$81.65
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $226.85 / $237.54 / $237.54	Professional	TC	$226.85	$237.54	$237.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $207.15 / $225.98 / $235.40	Professional		$207.15	$225.98	$235.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.40 / $65.89 / $68.64	Professional	26	$60.40	$65.89	$68.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $146.75 / $160.09 / $166.76	Professional	TC	$146.75	$160.09	$166.76
United Facility/Professional Professional Modifier Low / Median / High Price $254.23 / $272.45 / $301.62	Professional		$254.23	$272.45	$301.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $75.87 / $93.03	Professional	26	$74.13	$75.87	$93.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.10 / $196.59 / $208.59	Professional	TC	$180.10	$196.59	$208.59
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $207.05 / $290.63 / $494.12	Professional		$207.05	$290.63	$494.12
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $63.15 / $84.66 / $142.22	Professional	26	$63.15	$84.66	$142.22
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $143.90 / $204.78 / $342.61	Professional	TC	$143.90	$204.78	$342.61