Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.19 / $26.28 / $30.92	Facility	26	$23.19	$26.28	$30.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.88 / $93.88 / $93.88	Professional		$93.88	$93.88	$93.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $78.06 / $78.06	Professional	TC	$78.06	$78.06	$78.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.26 / $131.83 / $205.01	Professional		$105.26	$131.83	$205.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.13 / $104.23 / $174.10	Professional	TC	$78.13	$104.23	$174.10
HMSA Facility/Professional Professional Modifier Low / Median / High Price $27.94 / $138.91 / $213.25	Professional		$27.94	$138.91	$213.25
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $173.04 / $181.19 / $183.17	Professional	TC	$173.04	$181.19	$183.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.05 / $182.23 / $212.60	Professional		$167.05	$182.23	$212.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.19 / $27.48 / $32.06	Professional	26	$25.19	$27.48	$32.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.86 / $154.75 / $163.78	Professional	TC	$141.86	$154.75	$163.78
United Facility/Professional Professional Modifier Low / Median / High Price $70.69 / $205.01 / $222.20	Professional		$70.69	$205.01	$222.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.81 / $174.10 / $184.29	Professional	TC	$56.81	$174.10	$184.29
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $123.20 / $209.42 / $290.31	Professional		$123.20	$209.42	$290.31
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $99.79 / $167.29 / $231.08	Professional	TC	$99.79	$167.29	$231.08