Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.25 / $47.89 / $56.34	Facility	26	$42.25	$47.89	$56.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $130.41 / $242.46	Professional		$109.14	$130.41	$242.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $42.75 / $59.92	Professional	26	$29.91	$42.75	$59.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $97.21 / $177.96	Professional	TC	$79.23	$97.21	$177.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $48.64 / $48.64	Facility	26	$48.64	$48.64	$48.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.34 / $145.58 / $205.36	Professional		$104.34	$145.58	$205.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $42.20 / $60.21	Professional	26	$38.43	$42.20	$60.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.91 / $107.01 / $157.49	Professional	TC	$65.91	$107.01	$157.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $128.84 / $235.40	Professional		$50.13	$128.84	$235.40
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $54.96 / $57.55 / $58.98	Professional	26	$54.96	$57.55	$58.98
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $146.50 / $168.48 / $176.42	Professional	TC	$146.50	$168.48	$176.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $161.38 / $176.06 / $205.41	Professional		$161.38	$176.06	$205.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.90 / $50.08 / $58.42	Professional	26	$45.90	$50.08	$58.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $115.49 / $125.99 / $133.34	Professional	TC	$115.49	$125.99	$133.34
United Facility/Professional Professional Modifier Low / Median / High Price $76.06 / $198.07 / $233.18	Professional		$76.06	$198.07	$233.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.12 / $56.34 / $71.19	Professional	26	$26.12	$56.34	$71.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.95 / $141.74 / $161.99	Professional	TC	$49.95	$141.74	$161.99
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $138.36 / $208.02 / $328.26	Professional		$138.36	$208.02	$328.26
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $36.93 / $60.34 / $82.94	Professional	26	$36.93	$60.34	$82.94
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $94.48 / $145.28 / $245.32	Professional	TC	$94.48	$145.28	$245.32