Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $51.29 / $60.26	Facility	26	$44.67	$51.29	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $112.20 / $245.47	Professional		$69.18	$112.20	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $43.65 / $112.20	Professional	26	$14.13	$43.65	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $177.83	Professional	TC	$41.69	$60.26	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $204.17 / $660.69	Professional		$100.00	$204.17	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $57.54	Professional	26	$16.98	$22.39	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $181.97 / $645.65	Professional	TC	$70.79	$181.97	$645.65
HMSA Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $831.76 / $912.01	Professional		$575.44	$831.76	$912.01
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $60.26 / $63.10	Professional	26	$58.88	$60.26	$63.10
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $645.65 / $676.08	Professional	TC	$645.65	$645.65	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $123.03 / $144.54	Professional		$112.20	$123.03	$144.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $53.70 / $63.10	Professional	26	$48.98	$53.70	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $69.18 / $81.28	Professional	TC	$63.10	$69.18	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $426.58	Professional		$112.20	$134.90	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $52.48 / $93.33	Professional	26	$22.91	$52.48	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $102.33 / $398.11	Professional	TC	$60.26	$102.33	$398.11
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $741.31	Professional		$128.82	$162.18	$741.31
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $37.15 / $69.18	Professional	26	$20.42	$37.15	$69.18
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $141.25 / $724.44	Professional	TC	$72.44	$141.25	$724.44