Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.45 / $31.11 / $36.60	Facility	26	$27.45	$31.11	$36.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $101.07 / $466.72	Professional		$86.38	$101.07	$466.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.08 / $28.11 / $108.63	Professional	26	$6.08	$28.11	$108.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.60 / $75.81 / $94.41	Professional	TC	$62.60	$75.81	$94.41
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $86.52 / $137.33	Professional		$46.69	$86.52	$137.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $34.65 / $40.67	Professional	26	$21.94	$34.65	$40.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.75 / $49.92 / $132.76	Professional	TC	$24.75	$49.92	$132.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $33.97 / $111.75 / $133.08	Professional		$33.97	$111.75	$133.08
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.38 / $38.09 / $39.04	Professional	26	$36.38	$38.09	$39.04
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $90.72 / $94.99 / $94.99	Professional	TC	$90.72	$94.99	$94.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.50 / $76.91 / $89.73	Professional		$70.50	$76.91	$89.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $32.53 / $37.95	Professional	26	$29.82	$32.53	$37.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.68 / $44.38 / $51.77	Professional	TC	$40.68	$44.38	$51.77
United Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $86.52 / $97.40	Professional		$64.89	$86.52	$97.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.45 / $36.60 / $45.63	Professional	26	$27.45	$36.60	$45.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.53 / $49.92 / $51.77	Professional	TC	$35.53	$49.92	$51.77
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $128.56 / $191.68	Professional		$78.68	$128.56	$191.68
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $27.42 / $42.22 / $73.68	Professional	26	$27.42	$42.22	$73.68
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $44.42 / $81.91 / $142.40	Professional	TC	$44.42	$81.91	$142.40