Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.65 / $75.54 / $88.87	Facility	26	$66.65	$75.54	$88.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $330.20 / $550.14 / $777.56	Professional		$330.20	$550.14	$777.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.57 / $67.17 / $101.41	Professional	26	$46.57	$67.17	$101.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $283.63 / $476.60 / $676.14	Professional	TC	$283.63	$476.60	$676.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $545.90 / $545.90 / $753.57	Professional		$545.90	$545.90	$753.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $82.61 / $82.61 / $99.05	Professional	26	$82.61	$82.61	$99.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $463.29 / $463.29 / $654.52	Professional	TC	$463.29	$463.29	$654.52
HMSA Facility/Professional Professional Modifier Low / Median / High Price $85.18 / $110.85 / $700.87	Professional		$85.18	$110.85	$700.87
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $88.68 / $92.86 / $95.18	Professional	26	$88.68	$92.86	$95.18
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $580.65 / $608.01 / $608.01	Professional	TC	$580.65	$608.01	$608.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $511.26 / $557.74 / $580.98	Professional		$511.26	$557.74	$580.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.41 / $79.00 / $82.29	Professional	26	$72.41	$79.00	$82.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $438.86 / $478.75 / $498.70	Professional	TC	$438.86	$478.75	$498.70
United Facility/Professional Professional Modifier Low / Median / High Price $627.45 / $693.22 / $857.25	Professional		$627.45	$693.22	$857.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.87 / $100.51 / $113.58	Professional	26	$88.87	$100.51	$113.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $538.60 / $592.71 / $743.67	Professional	TC	$538.60	$592.71	$743.67
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $576.09 / $784.72 / $1,314.34	Professional		$576.09	$784.72	$1,314.34
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $81.39 / $105.02 / $174.16	Professional	26	$81.39	$105.02	$174.16
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $494.71 / $679.70 / $1,140.20	Professional	TC	$494.71	$679.70	$1,140.20