Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.72 / $29.15 / $34.29	Facility	26	$25.72	$29.15	$34.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $102.57 / $191.93	Professional		$78.68	$102.57	$191.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.64 / $27.39 / $88.00	Professional	26	$24.64	$27.39	$88.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.79 / $73.22 / $152.75	Professional	TC	$56.79	$73.22	$152.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.35 / $132.56 / $230.83	Professional		$82.35	$132.56	$230.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.84 / $34.29 / $59.52	Professional	26	$20.84	$34.29	$59.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.51 / $103.41 / $171.31	Professional	TC	$61.51	$103.41	$171.31
HMSA Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $129.60 / $158.33	Professional		$32.36	$129.60	$158.33
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $34.13 / $35.74 / $38.07	Professional	26	$34.13	$35.74	$38.07
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $117.07 / $122.59 / $127.41	Professional	TC	$117.07	$122.59	$127.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $127.07 / $138.62 / $161.72	Professional		$127.07	$138.62	$161.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.94 / $30.48 / $35.56	Professional	26	$27.94	$30.48	$35.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $99.13 / $108.14 / $126.17	Professional	TC	$99.13	$108.14	$126.17
United Facility/Professional Professional Modifier Low / Median / High Price $115.85 / $155.94 / $193.61	Professional		$115.85	$155.94	$193.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.72 / $34.29 / $43.38	Professional	26	$25.72	$34.29	$43.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.14 / $121.66 / $150.22	Professional	TC	$51.14	$121.66	$150.22
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $143.16 / $179.26 / $246.45	Professional		$143.16	$179.26	$246.45
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $31.41 / $40.67 / $66.59	Professional	26	$31.41	$40.67	$66.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $108.15 / $135.08 / $179.84	Professional	TC	$108.15	$135.08	$179.84