Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.78 / $40.54 / $47.71	Facility	26	$35.78	$40.54	$47.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.20 / $164.72 / $262.38	Professional		$125.20	$164.72	$262.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.20 / $28.11 / $54.58	Professional	26	$7.20	$28.11	$54.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.08 / $128.55 / $207.79	Professional	TC	$97.08	$128.55	$207.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $40.92 / $40.92	Facility	26	$40.92	$40.92	$40.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.69 / $181.28 / $389.57	Professional		$113.69	$181.28	$389.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.71 / $45.19 / $81.27	Professional	26	$28.71	$45.19	$81.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.98 / $140.72 / $308.30	Professional	TC	$84.98	$140.72	$308.30
HMSA Facility/Professional Professional Modifier Low / Median / High Price $42.86 / $158.53 / $226.30	Professional		$42.86	$158.53	$226.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $45.89 / $48.05 / $49.26	Professional	26	$45.89	$48.05	$49.26
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $164.64 / $172.40 / $187.71	Professional	TC	$164.64	$172.40	$187.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $189.58 / $221.17	Professional		$173.78	$189.58	$221.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.86 / $42.41 / $49.48	Professional	26	$38.86	$42.41	$49.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $147.16 / $171.70	Professional	TC	$134.90	$147.16	$171.70
United Facility/Professional Professional Modifier Low / Median / High Price $159.16 / $213.27 / $265.55	Professional		$159.16	$213.27	$265.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.78 / $47.71 / $60.47	Professional	26	$35.78	$47.71	$60.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.82 / $165.56 / $205.08	Professional	TC	$119.82	$165.56	$205.08
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $186.79 / $251.04 / $412.83	Professional		$186.79	$251.04	$412.83
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.29 / $55.36 / $91.59	Professional	26	$40.29	$55.36	$91.59
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $135.69 / $193.23 / $321.22	Professional	TC	$135.69	$193.23	$321.22