Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.65 / $40.40 / $47.53	Facility	26	$35.65	$40.40	$47.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $132.07 / $530.00	Professional		$97.96	$132.07	$530.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $54.52 / $197.89	Professional	26	$32.13	$54.52	$197.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.76 / $69.69 / $106.10	Professional	TC	$54.76	$69.69	$106.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.29 / $120.68 / $234.70	Professional		$72.29	$120.68	$234.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $44.85 / $81.78	Professional	26	$28.78	$44.85	$81.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.51 / $78.14 / $152.91	Professional	TC	$43.51	$78.14	$152.91
HMSA Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $109.45 / $136.35	Professional		$44.69	$109.45	$136.35
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $47.42 / $49.65 / $50.90	Professional	26	$47.42	$49.65	$50.90
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $82.80 / $86.70 / $89.25	Professional	TC	$82.80	$86.70	$89.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.61 / $117.40 / $136.96	Professional		$107.61	$117.40	$136.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $42.25 / $49.29	Professional	26	$38.72	$42.25	$49.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $75.14 / $87.67	Professional	TC	$68.88	$75.14	$87.67
United Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $132.07 / $160.54	Professional		$89.34	$132.07	$160.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.25 / $59.24 / $284.72	Professional	26	$38.25	$59.24	$284.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.40 / $87.90 / $430.42	Professional	TC	$63.40	$87.90	$430.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $110.08 / $148.37 / $251.18	Professional		$110.08	$148.37	$251.18
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $35.83 / $53.36 / $91.26	Professional	26	$35.83	$53.36	$91.26
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $68.90 / $95.21 / $159.91	Professional	TC	$68.90	$95.21	$159.91