Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $31.62 / $37.15	Facility	26	$27.54	$31.62	$37.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $190.55	Professional		$79.43	$114.82	$190.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $25.70 / $53.70	Professional	26	$20.89	$25.70	$53.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $89.13 / $151.36	Professional	TC	$57.54	$89.13	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $117.49 / $218.78	Professional		$89.13	$117.49	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $33.11 / $61.66	Professional	26	$23.44	$33.11	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $85.11 / $158.49	Professional	TC	$66.07	$85.11	$158.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $199.53 / $213.80	Professional		$45.71	$199.53	$213.80
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $37.15 / $38.90	Professional	26	$36.31	$37.15	$38.90
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $154.88 / $162.18	Professional	TC	$154.88	$154.88	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $177.83 / $208.93	Professional		$162.18	$177.83	$208.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $34.67 / $40.74	Professional	26	$32.36	$34.67	$40.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $141.25 / $165.96	Professional	TC	$131.83	$141.25	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $251.19	Professional		$131.83	$154.88	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $37.15 / $57.54	Professional	26	$32.36	$37.15	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $117.49 / $190.55	Professional	TC	$97.72	$117.49	$190.55
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $194.98 / $251.19	Professional		$125.89	$194.98	$251.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $41.69 / $60.26	Professional	26	$30.20	$41.69	$60.26
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $151.36 / $199.53	Professional	TC	$95.50	$151.36	$199.53