Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.07 / $37.47 / $44.09	Facility	26	$33.07	$37.47	$44.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.89 / $122.84 / $191.83	Professional		$99.89	$122.84	$191.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $46.94 / $114.70	Professional	26	$31.21	$46.94	$114.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.67 / $81.98 / $141.40	Professional	TC	$68.67	$81.98	$141.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.82 / $37.82 / $37.82	Facility	26	$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.71 / $133.21 / $160.81	Professional		$119.71	$133.21	$160.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.47 / $40.01 / $48.22	Professional	26	$37.47	$40.01	$48.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.70 / $94.57 / $112.63	Professional	TC	$79.70	$94.57	$112.63
HMSA Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $53.95 / $167.39	Professional		$39.36	$53.95	$167.39
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $43.16 / $45.19 / $46.32	Professional	26	$43.16	$45.19	$46.32
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $115.62 / $121.07 / $121.07	Professional	TC	$115.62	$121.07	$121.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.70 / $139.31 / $162.53	Professional		$127.70	$139.31	$162.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.93 / $39.19 / $45.72	Professional	26	$35.93	$39.19	$45.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.77 / $100.12 / $105.96	Professional	TC	$91.77	$100.12	$105.96
United Facility/Professional Professional Modifier Low / Median / High Price $86.60 / $156.72 / $183.20	Professional		$86.60	$156.72	$183.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.19 / $44.09 / $55.28	Professional	26	$20.19	$44.09	$55.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $108.10 / $127.92	Professional	TC	$39.47	$108.10	$127.92
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $143.84 / $191.19 / $299.19	Professional		$143.84	$191.19	$299.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.39 / $56.82 / $90.26	Professional	26	$40.39	$56.82	$90.26
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $103.45 / $139.31 / $208.94	Professional	TC	$103.45	$139.31	$208.94