Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.91 / $185.43 / $446.13	Professional		$110.91	$185.43	$446.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.46 / $59.28 / $67.14	Professional	26	$43.46	$59.28	$67.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.17 / $85.51 / $92.72	Professional	52	$67.17	$85.51	$92.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $76.18 / $126.14 / $158.51	Professional	TC	$76.18	$126.14	$158.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $210.30 / $249.37	Professional		$103.64	$210.30	$249.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $80.98 / $101.17	Professional	26	$43.75	$80.98	$101.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $59.88 / $139.57 / $167.07	Professional	TC	$59.88	$139.57	$167.07
HMSA Facility/Professional Professional Modifier Low / Median / High Price $97.21 / $204.11 / $316.42	Professional		$97.21	$204.11	$316.42
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $102.45 / $109.21 / $114.36	Professional	26	$102.45	$109.21	$114.36
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $192.97 / $202.06 / $202.06	Professional	TC	$192.97	$202.06	$202.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.77 / $121.93 / $142.25	Professional		$111.77	$121.93	$142.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.18 / $51.47 / $60.05	Professional	26	$47.18	$51.47	$60.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $64.58 / $70.45 / $82.19	Professional	TC	$64.58	$70.45	$82.19
United Facility/Professional Professional Modifier Low / Median / High Price $103.64 / $127.01 / $196.34	Professional		$103.64	$127.01	$196.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.75 / $53.61 / $71.51	Professional	26	$43.75	$53.61	$71.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.88 / $73.39 / $124.83	Professional	TC	$59.88	$73.39	$124.83
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $86.32 / $144.60 / $232.92	Professional		$86.32	$144.60	$232.92
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $57.65 / $73.14	Professional	26	$32.54	$57.65	$73.14
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $68.26 / $151.52	Professional	TC	$38.54	$68.26	$151.52