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 $75.43 / $88.55 / $141.40	Professional		$75.43	$88.55	$141.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $35.77 / $50.42	Professional	26	$31.21	$35.77	$50.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.21 / $52.77 / $90.98	Professional	TC	$44.21	$52.77	$90.98
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 $91.29 / $99.10 / $120.70	Professional		$91.29	$99.10	$120.70
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 $51.29 / $60.90 / $72.50	Professional	TC	$51.29	$60.90	$72.50
HMSA Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $53.95 / $123.31	Professional		$39.36	$53.95	$123.31
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 $74.59 / $78.12 / $78.12	Professional	TC	$74.59	$78.12	$78.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $103.63 / $120.90	Professional		$95.00	$103.63	$120.90
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 $59.07 / $64.44 / $68.20	Professional	TC	$59.07	$64.44	$68.20
United Facility/Professional Professional Modifier Low / Median / High Price $45.53 / $116.59 / $137.65	Professional		$45.53	$116.59	$137.65
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 $25.34 / $72.50 / $82.37	Professional	TC	$25.34	$72.50	$82.37
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $106.97 / $141.77 / $211.03	Professional		$106.97	$141.77	$211.03
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.39 / $51.88 / $84.73	Professional	26	$40.39	$51.88	$84.73
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $66.59 / $89.89 / $126.29	Professional	TC	$66.59	$89.89	$126.29