Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $116.56 / $132.10 / $161.88	Facility	26	$116.56	$132.10	$161.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.22 / $253.64 / $351.30	Professional		$188.22	$253.64	$351.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.15 / $134.83 / $202.74	Professional	26	$110.15	$134.83	$202.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $96.37 / $137.05	Professional	TC	$78.06	$96.37	$137.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.75 / $288.77 / $304.02	Professional		$221.75	$288.77	$304.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.10 / $162.31 / $171.28	Professional	26	$132.10	$162.31	$171.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.65 / $130.27 / $132.74	Professional	TC	$89.65	$130.27	$132.74
HMSA Facility/Professional Professional Modifier Low / Median / High Price $113.53 / $155.21 / $307.38	Professional		$113.53	$155.21	$307.38
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $161.94 / $169.58 / $173.82	Professional	26	$161.94	$169.58	$173.82
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $127.55 / $133.56 / $133.56	Professional	TC	$127.55	$133.56	$133.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.14 / $260.88 / $304.36	Professional		$239.14	$260.88	$304.36
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $142.46 / $155.41 / $181.31	Professional	26	$142.46	$155.41	$181.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $96.68 / $105.47 / $123.05	Professional	TC	$96.68	$105.47	$123.05
United Facility/Professional Professional Modifier Low / Median / High Price $221.75 / $271.75 / $380.54	Professional		$221.75	$271.75	$380.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.10 / $161.88 / $214.85	Professional	26	$132.10	$161.88	$214.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.65 / $109.86 / $165.69	Professional	TC	$89.65	$109.86	$165.69
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $177.58 / $275.60 / $314.58	Professional		$177.58	$275.60	$314.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $100.26 / $154.37 / $177.61	Professional	26	$100.26	$154.37	$177.61
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $77.33 / $121.23 / $136.97	Professional	TC	$77.33	$121.23	$136.97