Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $13.32 / $15.67	Facility	26	$11.76	$13.32	$15.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.89 / $92.58 / $184.58	Professional		$90.89	$92.58	$184.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $12.35 / $51.30	Professional	26	$11.77	$12.35	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.11 / $80.22 / $166.62	Professional	TC	$79.11	$80.22	$166.62
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $126.17 / $145.19 / $180.82	Professional		$126.17	$145.19	$180.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.52 / $13.42 / $17.04	Professional	26	$12.52	$13.42	$17.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $116.44 / $132.68 / $167.01	Professional	TC	$116.44	$132.68	$167.01
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.92 / $165.26 / $214.85	Professional		$13.92	$165.26	$214.85
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $15.98 / $16.38	Professional	26	$15.26	$15.98	$16.38
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $150.00 / $157.07 / $157.07	Professional	TC	$150.00	$157.07	$157.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.90 / $131.88 / $153.87	Professional		$120.90	$131.88	$153.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.77 / $13.93 / $16.25	Professional	26	$12.77	$13.93	$16.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $108.13 / $117.96 / $124.84	Professional	TC	$108.13	$117.96	$124.84
United Facility/Professional Professional Modifier Low / Median / High Price $64.53 / $148.38 / $197.01	Professional		$64.53	$148.38	$197.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $15.67 / $19.53	Professional	26	$7.45	$15.67	$19.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.08 / $132.71 / $233.74	Professional	TC	$57.08	$132.71	$233.74
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $134.30 / $161.52 / $204.53	Professional		$134.30	$161.52	$204.53
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.08 / $17.48 / $29.76	Professional	26	$13.08	$17.48	$29.76
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $118.38 / $142.36 / $172.80	Professional	TC	$118.38	$142.36	$172.80