Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.82 / $31.53 / $37.10	Facility	26	$27.82	$31.53	$37.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.73 / $108.53 / $225.70	Professional		$90.73	$108.53	$225.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.26 / $26.99 / $42.69	Professional	26	$24.26	$26.99	$42.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.45 / $81.53 / $183.00	Professional	TC	$66.45	$81.53	$183.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.15 / $32.15 / $32.15	Facility	26	$32.15	$32.15	$32.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.43 / $116.85 / $182.86	Professional		$114.43	$116.85	$182.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.25 / $31.53 / $40.99	Professional	26	$30.25	$31.53	$40.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.44 / $84.18 / $145.75	Professional	TC	$83.44	$84.18	$145.75
HMSA Facility/Professional Professional Modifier Low / Median / High Price $33.31 / $153.11 / $201.19	Professional		$33.31	$153.11	$201.19
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.51 / $38.22 / $39.19	Professional	26	$36.51	$38.22	$39.19
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $154.71 / $162.00 / $162.00	Professional	TC	$154.71	$162.00	$162.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $149.00 / $162.54 / $189.63	Professional		$149.00	$162.54	$189.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.23 / $32.97 / $38.47	Professional	26	$30.23	$32.97	$38.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $118.76 / $129.55 / $137.11	Professional	TC	$118.76	$129.55	$137.11
United Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $182.86 / $209.24	Professional		$67.23	$182.86	$209.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.72 / $46.64 / $220.29	Professional	26	$29.72	$46.64	$220.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.14 / $145.75 / $162.60	Professional	TC	$50.14	$145.75	$162.60
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $126.77 / $188.71 / $267.95	Professional		$126.77	$188.71	$267.95
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $41.07 / $70.08	Professional	26	$27.47	$41.07	$70.08
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $96.09 / $145.43 / $204.16	Professional	TC	$96.09	$145.43	$204.16