Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $37.15 / $43.65	Facility	26	$32.36	$37.15	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $537.03	Professional		$91.20	$141.25	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $46.77 / $144.54	Professional	26	$28.18	$46.77	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $97.72 / $302.00	Professional	TC	$61.66	$97.72	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $128.82 / $269.15	Professional		$75.86	$128.82	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $38.02 / $74.13	Professional	26	$24.55	$38.02	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $89.13 / $194.98	Professional	TC	$51.29	$89.13	$194.98
HMSA Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $144.54 / $162.18	Professional		$53.70	$144.54	$162.18
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.71 / $46.77	Professional	26	$43.65	$45.71	$46.77
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $109.65 / $117.49	Professional	TC	$104.71	$109.65	$117.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $138.04 / $162.18	Professional		$128.82	$138.04	$162.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.81 / $46.77	Professional	26	$36.31	$39.81	$46.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $100.00 / $114.82	Professional	TC	$91.20	$100.00	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $147.91 / $213.80	Professional		$112.20	$147.91	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $66.07	Professional	26	$32.36	$42.66	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $104.71 / $151.36	Professional	TC	$75.86	$104.71	$151.36
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $165.96 / $251.19	Professional		$134.90	$165.96	$251.19
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $50.12 / $72.44	Professional	26	$36.31	$50.12	$72.44
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $120.23 / $177.83	Professional	TC	$87.10	$120.23	$177.83