Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $48.98 / $57.54	Facility	26	$42.66	$48.98	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $436.52	Professional		$51.29	$91.20	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $40.74 / $117.49	Professional	26	$23.44	$40.74	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $52.48 / $102.33	Professional	TC	$10.00	$52.48	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $131.83 / $213.80	Professional		$42.66	$131.83	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $37.15 / $67.61	Professional	26	$27.54	$37.15	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.32 / $89.13 / $151.36	Professional	TC	$8.32	$89.13	$151.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $141.25 / $162.18	Professional		$67.61	$141.25	$162.18
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $56.23 / $57.54	Professional	26	$53.70	$56.23	$57.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $107.15 / $112.20	Professional	TC	$102.33	$107.15	$112.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.61 / $79.43	Professional		$61.66	$67.61	$79.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $52.48 / $61.66	Professional	26	$47.86	$52.48	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $14.79 / $17.38	Professional	TC	$13.49	$14.79	$17.38
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $95.50 / $169.82	Professional		$54.95	$95.50	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $64.57	Professional	26	$32.36	$46.77	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $46.77 / $125.89	Professional	TC	$11.75	$46.77	$125.89
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $128.82 / $257.04	Professional		$67.61	$128.82	$257.04
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $52.48 / $66.07	Professional	26	$31.62	$52.48	$66.07
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $107.15 / $194.98	Professional	TC	$17.38	$107.15	$194.98