Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.53 / $32.34 / $38.04	Facility	26	$28.53	$32.34	$38.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.26 / $114.02 / $189.03	Professional		$98.26	$114.02	$189.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.55 / $38.04 / $67.15	Professional	26	$23.55	$38.04	$67.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.70 / $86.69 / $145.38	Professional	TC	$66.70	$86.69	$145.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.69 / $136.80 / $264.33	Professional		$80.69	$136.80	$264.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.73 / $36.01 / $63.60	Professional	26	$22.73	$36.01	$63.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.96 / $98.51 / $200.73	Professional	TC	$57.96	$98.51	$200.73
HMSA Facility/Professional Professional Modifier Low / Median / High Price $34.19 / $142.65 / $151.38	Professional		$34.19	$142.65	$151.38
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.61 / $38.35 / $39.29	Professional	26	$36.61	$38.35	$39.29
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $106.03 / $111.03 / $111.03	Professional	TC	$106.03	$111.03	$111.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $125.42 / $136.82 / $159.63	Professional		$125.42	$136.82	$159.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.00 / $33.82 / $39.45	Professional	26	$31.00	$33.82	$39.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.44 / $103.02 / $120.19	Professional	TC	$94.44	$103.02	$120.19
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $153.93 / $182.78	Professional		$109.71	$153.93	$182.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $46.80 / $224.48	Professional	26	$30.32	$46.80	$224.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.94 / $115.90 / $135.97	Professional	TC	$73.94	$115.90	$135.97
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $141.30 / $174.41 / $230.87	Professional		$141.30	$174.41	$230.87
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $34.84 / $43.88 / $59.39	Professional	26	$34.84	$43.88	$59.39
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $106.45 / $130.53 / $171.49	Professional	TC	$106.45	$130.53	$171.49