Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $36.69 / $43.16	Facility	26	$32.36	$36.69	$43.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.48 / $206.60 / $431.11	Professional		$118.48	$206.60	$431.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.53 / $45.33 / $168.21	Professional	26	$30.53	$45.33	$168.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.80 / $107.91 / $206.32	Professional	TC	$85.80	$107.91	$206.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.04 / $37.04 / $37.04	Facility	26	$37.04	$37.04	$37.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.51 / $176.36 / $272.18	Professional		$106.51	$176.36	$272.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $40.69 / $71.98	Professional	26	$26.17	$40.69	$71.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.06 / $139.66 / $231.49	Professional	TC	$70.06	$139.66	$231.49
HMSA Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $149.31 / $207.09	Professional		$40.21	$149.31	$207.09
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $43.06 / $45.09 / $46.22	Professional	26	$43.06	$45.09	$46.22
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $154.71 / $162.00 / $162.00	Professional	TC	$154.71	$162.00	$162.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.06 / $184.43 / $215.17	Professional		$169.06	$184.43	$215.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $38.36 / $44.76	Professional	26	$35.17	$38.36	$44.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $133.88 / $146.05 / $170.39	Professional	TC	$133.88	$146.05	$170.39
United Facility/Professional Professional Modifier Low / Median / High Price $139.38 / $207.48 / $268.38	Professional		$139.38	$207.48	$268.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.00 / $43.16 / $53.13	Professional	26	$31.00	$43.16	$53.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.29 / $164.31 / $215.25	Professional	TC	$89.29	$164.31	$215.25
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $136.76 / $218.56 / $263.58	Professional		$136.76	$218.56	$263.58
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $49.51 / $81.93	Professional	26	$33.02	$49.51	$81.93
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $88.19 / $166.69 / $204.16	Professional	TC	$88.19	$166.69	$204.16