Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.19 / $22.88 / $26.92	Facility	26	$20.19	$22.88	$26.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $86.40 / $178.24	Professional		$73.73	$86.40	$178.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $20.17 / $30.95	Professional	26	$18.16	$20.17	$30.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.57 / $65.59 / $147.28	Professional	TC	$55.57	$65.59	$147.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.72 / $22.72 / $22.72	Facility	26	$22.72	$22.72	$22.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.46 / $107.31 / $144.32	Professional		$88.46	$107.31	$144.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.22 / $23.41 / $28.20	Professional	26	$22.22	$23.41	$28.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.05 / $81.48 / $117.40	Professional	TC	$65.05	$81.48	$117.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $24.90 / $33.68 / $139.44	Professional		$24.90	$33.68	$139.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $26.25 / $27.97 / $29.29	Professional	26	$26.25	$27.97	$29.29
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $113.20 / $118.53 / $123.20	Professional	TC	$113.20	$118.53	$123.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.59 / $128.28 / $149.66	Professional		$117.59	$128.28	$149.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.93 / $23.93 / $27.92	Professional	26	$21.93	$23.93	$27.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $95.66 / $104.35 / $110.44	Professional	TC	$95.66	$104.35	$110.44
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $118.75 / $690.98	Professional		$86.60	$118.75	$690.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $26.92 / $32.94	Professional	26	$12.02	$26.92	$32.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.71 / $117.40 / $125.45	Professional	TC	$38.71	$117.40	$125.45
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $132.49 / $162.10 / $227.68	Professional		$132.49	$162.10	$227.68
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $30.06 / $52.45	Professional	26	$24.66	$30.06	$52.45
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $107.83 / $132.04 / $176.04	Professional	TC	$107.83	$132.04	$176.04