Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.09 / $29.57 / $34.79	Facility	26	$26.09	$29.57	$34.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $110.69 / $177.01	Professional		$92.43	$110.69	$177.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.17 / $25.71 / $39.81	Professional	26	$23.17	$25.71	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.26 / $84.97 / $137.19	Professional	TC	$69.26	$84.97	$137.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.96 / $110.14 / $160.16	Professional		$90.96	$110.14	$160.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.90 / $30.73 / $37.39	Professional	26	$27.90	$30.73	$37.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.06 / $79.40 / $121.52	Professional	TC	$63.06	$79.40	$121.52
HMSA Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $98.02 / $155.46	Professional		$30.40	$98.02	$155.46
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $33.31 / $34.88 / $35.76	Professional	26	$33.31	$34.88	$35.76
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $105.48 / $121.31 / $127.03	Professional	TC	$105.48	$121.31	$127.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.46 / $128.13 / $149.49	Professional		$117.46	$128.13	$149.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.35 / $30.92 / $36.08	Professional	26	$28.35	$30.92	$36.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.11 / $97.21 / $102.88	Professional	TC	$89.11	$97.21	$102.88
United Facility/Professional Professional Modifier Low / Median / High Price $52.15 / $144.15 / $160.79	Professional		$52.15	$144.15	$160.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.11 / $34.79 / $44.01	Professional	26	$16.11	$34.79	$44.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $109.36 / $116.78	Professional	TC	$36.04	$109.36	$116.78
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $126.48 / $161.72 / $226.14	Professional		$126.48	$161.72	$226.14
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $29.14 / $40.70 / $65.25	Professional	26	$29.14	$40.70	$65.25
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $96.64 / $125.37 / $171.79	Professional	TC	$96.64	$125.37	$171.79