Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $40.74 / $47.86	Facility	26	$35.48	$40.74	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $407.38	Professional		$120.23	$154.88	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.02 / $141.25	Professional	26	$30.20	$38.02	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $120.23 / $245.47	Professional	TC	$93.33	$120.23	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $177.83 / $389.05	Professional		$107.15	$177.83	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $41.69 / $81.28	Professional	26	$27.54	$41.69	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $131.83 / $309.03	Professional	TC	$79.43	$131.83	$309.03
HMSA Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $218.78 / $234.42	Professional		$54.95	$218.78	$234.42
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $47.86 / $48.98	Professional	26	$45.71	$47.86	$48.98
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $173.78 / $186.21	Professional	TC	$165.96	$173.78	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $223.87	Professional		$173.78	$190.55	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $42.66 / $48.98	Professional	26	$38.90	$42.66	$48.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $147.91 / $173.78	Professional	TC	$134.90	$147.91	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $302.00	Professional		$158.49	$181.97	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $46.77 / $72.44	Professional	26	$35.48	$46.77	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $141.25 / $229.09	Professional	TC	$120.23	$141.25	$229.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $239.88 / $416.87	Professional		$186.21	$239.88	$416.87
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $53.70 / $91.20	Professional	26	$40.74	$53.70	$91.20
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $186.21 / $323.59	Professional	TC	$134.90	$186.21	$323.59