Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $45.71 / $53.70	Facility	26	$39.81	$45.71	$53.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $186.21 / $676.08	Professional		$114.82	$186.21	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $44.67 / $181.97	Professional	26	$38.02	$44.67	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $120.23 / $281.84	Professional	TC	$69.18	$120.23	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $204.17 / $281.84	Professional		$131.83	$204.17	$281.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $50.12 / $89.13	Professional	26	$33.88	$50.12	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $154.88 / $204.17	Professional	TC	$85.11	$154.88	$204.17
HMSA Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $309.03 / $346.74	Professional		$213.80	$309.03	$346.74
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $54.95 / $57.54	Professional	26	$52.48	$54.95	$57.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $239.88 / $251.19	Professional	TC	$239.88	$239.88	$251.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $138.04 / $173.78	Professional		$120.23	$138.04	$173.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $47.86 / $60.26	Professional	26	$41.69	$47.86	$60.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $91.20 / $114.82	Professional	TC	$77.62	$91.20	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $295.12	Professional		$125.89	$173.78	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $87.10	Professional	26	$46.77	$53.70	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $109.65 / $239.88	Professional	TC	$81.28	$109.65	$239.88
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $218.78 / $467.74	Professional		$147.91	$218.78	$467.74
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $60.26 / $89.13	Professional	26	$45.71	$60.26	$89.13
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $169.82 / $389.05	Professional	TC	$97.72	$169.82	$389.05