Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.03 / $306.95 / $1,136.00	Professional		$220.03	$306.95	$1,136.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $91.61 / $99.13 / $379.00	Professional	26	$91.61	$99.13	$379.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $172.59 / $181.59 / $279.43	Professional	TC	$172.59	$181.59	$279.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.46 / $93.46 / $93.46	Facility	26	$93.46	$93.46	$93.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.47 / $306.95 / $661.96	Professional		$212.47	$306.95	$661.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.53 / $100.70 / $182.05	Professional	26	$77.53	$100.70	$182.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.94 / $206.25 / $479.91	Professional	TC	$134.94	$206.25	$479.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $127.68 / $369.41 / $420.64	Professional		$127.68	$369.41	$420.64
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $136.74 / $143.18 / $146.76	Professional	26	$136.74	$143.18	$146.76
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $264.97 / $277.45 / $277.45	Professional	TC	$264.97	$277.45	$277.45
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $270.12 / $294.67 / $343.78	Professional		$270.12	$294.67	$343.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $88.62 / $96.67 / $112.78	Professional	26	$88.62	$96.67	$112.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $181.50 / $198.00 / $231.00	Professional	TC	$181.50	$198.00	$231.00
United Facility/Professional Professional Modifier Low / Median / High Price $250.47 / $306.95 / $395.09	Professional		$250.47	$306.95	$395.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $82.17 / $100.70 / $135.18	Professional	26	$82.17	$100.70	$135.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.51 / $206.25 / $259.91	Professional	TC	$158.51	$206.25	$259.91
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $226.32 / $307.39 / $751.07	Professional		$226.32	$307.39	$751.07
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $74.23 / $101.30 / $179.10	Professional	26	$74.23	$101.30	$179.10
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $152.09 / $203.98 / $347.04	Professional	TC	$152.09	$203.98	$347.04