Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.52 / $42.53 / $50.03	Facility	26	$37.52	$42.53	$50.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.73 / $98.77 / $420.00	Professional		$83.73	$98.77	$420.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.07 / $39.78 / $197.86	Professional	26	$34.07	$39.78	$197.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.65 / $60.90 / $119.70	Professional	TC	$49.65	$60.90	$119.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.19 / $43.19 / $43.19	Facility	26	$43.19	$43.19	$43.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.03 / $125.27 / $186.01	Professional		$73.03	$125.27	$186.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.53 / $46.49 / $54.43	Professional	26	$42.53	$46.49	$54.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.84 / $71.18 / $140.53	Professional	TC	$38.84	$71.18	$140.53
HMSA Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $67.15 / $112.45	Professional		$49.63	$67.15	$112.45
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $48.82 / $56.69 / $59.36	Professional	26	$48.82	$56.69	$59.36
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $53.38 / $55.90 / $58.39	Professional	TC	$53.38	$55.90	$58.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.86 / $100.21 / $116.91	Professional		$91.86	$100.21	$116.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.77 / $44.47 / $51.88	Professional	26	$40.77	$44.47	$51.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.10 / $55.74 / $58.99	Professional	TC	$51.10	$55.74	$58.99
United Facility/Professional Professional Modifier Low / Median / High Price $41.99 / $112.74 / $118.19	Professional		$41.99	$112.74	$118.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $50.03 / $62.73	Professional	26	$24.07	$50.03	$62.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $55.46 / $62.71	Professional	TC	$30.85	$55.46	$62.71
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $100.94 / $122.60 / $272.82	Professional		$100.94	$122.60	$272.82
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $42.22 / $58.03 / $95.54	Professional	26	$42.22	$58.03	$95.54
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $53.16 / $66.91 / $203.05	Professional	TC	$53.16	$66.91	$203.05