Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.01 / $37.40 / $44.01	Facility	26	$33.01	$37.40	$44.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.20 / $88.63 / $130.90	Professional		$76.20	$88.63	$130.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.14 / $33.40 / $51.26	Professional	26	$27.14	$33.40	$51.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $60.52 / $79.63	Professional	TC	$44.17	$60.52	$79.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.24 / $36.24 / $36.24	Facility	26	$36.24	$36.24	$36.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $107.47 / $232.57	Professional		$58.61	$107.47	$232.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $40.22 / $78.73	Professional	26	$25.75	$40.22	$78.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.86 / $63.46 / $153.84	Professional	TC	$32.86	$63.46	$153.84
HMSA Facility/Professional Professional Modifier Low / Median / High Price $42.61 / $170.59 / $181.16	Professional		$42.61	$170.59	$181.16
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $44.11 / $46.19 / $47.34	Professional	26	$44.11	$46.19	$47.34
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $126.48 / $132.44 / $132.44	Professional	TC	$126.48	$132.44	$132.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.57 / $95.53 / $111.45	Professional		$87.57	$95.53	$111.45
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $39.11 / $45.64	Professional	26	$35.86	$39.11	$45.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $51.71 / $56.41 / $65.81	Professional	TC	$51.71	$56.41	$65.81
United Facility/Professional Professional Modifier Low / Median / High Price $80.61 / $107.47 / $168.56	Professional		$80.61	$107.47	$168.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.01 / $44.01 / $57.96	Professional	26	$33.01	$44.01	$57.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.18 / $63.46 / $110.60	Professional	TC	$50.18	$63.46	$110.60
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $77.87 / $125.71 / $220.54	Professional		$77.87	$125.71	$220.54
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.97 / $49.68 / $88.41	Professional	26	$33.97	$49.68	$88.41
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $43.57 / $75.34 / $139.88	Professional	TC	$43.57	$75.34	$139.88