Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.96 / $45.29 / $53.28	Facility	26	$39.96	$45.29	$53.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.92 / $72.92 / $72.92	Professional		$72.92	$72.92	$72.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.83 / $45.83 / $45.83	Professional	TC	$45.83	$45.83	$45.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $45.47	Facility	26	$45.47	$45.47	$45.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.72 / $179.26 / $256.86	Professional		$112.72	$179.26	$256.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.09 / $128.10 / $207.25	Professional	TC	$75.09	$128.10	$207.25
HMSA Facility/Professional Professional Modifier Low / Median / High Price $46.25 / $258.79 / $3,102.00	Professional		$46.25	$258.79	$3,102.00
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $206.69 / $216.43 / $216.58	Professional	TC	$206.69	$216.43	$216.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.02 / $138.56 / $161.66	Professional		$127.02	$138.56	$161.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $47.36 / $55.26	Professional	26	$43.42	$47.36	$55.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $83.60 / $91.20 / $96.52	Professional	TC	$83.60	$91.20	$96.52
United Facility/Professional Professional Modifier Low / Median / High Price $56.89 / $155.88 / $171.77	Professional		$56.89	$155.88	$171.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.18 / $102.60 / $114.70	Professional	TC	$33.18	$102.60	$114.70
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $141.38 / $203.56 / $339.59	Professional		$141.38	$203.56	$339.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $93.16 / $134.11 / $264.42	Professional	TC	$93.16	$134.11	$264.42