Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.60 / $56.22 / $66.14	Facility	26	$49.60	$56.22	$66.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.08 / $357.92 / $619.77	Professional		$260.08	$357.92	$619.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $48.54 / $75.56	Professional	26	$34.13	$48.54	$75.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.96 / $308.92 / $544.17	Professional	TC	$225.96	$308.92	$544.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.33 / $323.33 / $551.66	Professional		$323.33	$323.33	$551.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.43 / $61.43 / $71.11	Professional	26	$61.43	$61.43	$71.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $261.91 / $261.91 / $480.56	Professional	TC	$261.91	$261.91	$480.56
HMSA Facility/Professional Professional Modifier Low / Median / High Price $83.44 / $499.81 / $545.66	Professional		$83.44	$499.81	$545.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $68.98 / $72.23 / $74.04	Professional	26	$68.98	$72.23	$74.04
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $452.14 / $473.44 / $487.17	Professional	TC	$452.14	$473.44	$487.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $407.10 / $444.11 / $462.61	Professional		$407.10	$444.11	$462.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.89 / $58.79 / $61.24	Professional	26	$53.89	$58.79	$61.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $353.21 / $385.32 / $401.38	Professional	TC	$353.21	$385.32	$401.38
United Facility/Professional Professional Modifier Low / Median / High Price $448.35 / $499.62 / $677.81	Professional		$448.35	$499.62	$677.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $66.14 / $68.48 / $82.79	Professional	26	$66.14	$68.48	$82.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $379.87 / $433.49 / $595.02	Professional	TC	$379.87	$433.49	$595.02
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $384.09 / $584.49 / $935.62	Professional		$384.09	$584.49	$935.62
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $55.86 / $77.95 / $124.20	Professional	26	$55.86	$77.95	$124.20
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $337.19 / $508.87 / $811.42	Professional	TC	$337.19	$508.87	$811.42