Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $139.30 / $157.88 / $193.48	Facility	26	$139.30	$157.88	$193.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.53 / $296.08 / $747.00	Professional		$220.53	$296.08	$747.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $132.22 / $154.82 / $242.34	Professional	26	$132.22	$154.82	$242.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.31 / $109.04 / $152.46	Professional	TC	$88.31	$109.04	$152.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.56 / $318.86 / $355.56	Professional		$257.56	$318.86	$355.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $157.88 / $194.10 / $205.38	Professional	26	$157.88	$194.10	$205.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.69 / $132.76 / $150.19	Professional	TC	$99.69	$132.76	$150.19
HMSA Facility/Professional Professional Modifier Low / Median / High Price $128.47 / $175.66 / $360.13	Professional		$128.47	$175.66	$360.13
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $194.70 / $203.87 / $208.97	Professional	26	$194.70	$203.87	$208.97
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $144.35 / $151.15 / $151.15	Professional	TC	$144.35	$151.15	$151.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $277.76 / $303.01 / $353.51	Professional		$277.76	$303.01	$353.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $170.26 / $185.74 / $216.69	Professional	26	$170.26	$185.74	$216.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.51 / $117.29 / $136.84	Professional	TC	$107.51	$117.29	$136.84
United Facility/Professional Professional Modifier Low / Median / High Price $257.56 / $315.64 / $434.21	Professional		$257.56	$315.64	$434.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $157.88 / $193.48 / $255.77	Professional	26	$157.88	$193.48	$255.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.69 / $122.18 / $178.44	Professional	TC	$99.69	$122.18	$178.44
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $195.14 / $317.80 / $345.67	Professional		$195.14	$317.80	$345.67
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $116.45 / $185.04 / $206.29	Professional	26	$116.45	$185.04	$206.29
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $78.69 / $128.15 / $139.38	Professional	TC	$78.69	$128.15	$139.38