Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.53 / $43.66 / $51.37	Facility	26	$38.53	$43.66	$51.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $189.39 / $210.82 / $772.95	Professional		$189.39	$210.82	$772.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $52.91 / $157.76	Professional	26	$32.20	$52.91	$157.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.46 / $256.44 / $601.20	Professional	TC	$159.46	$256.44	$601.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.82 / $177.34 / $397.56	Professional		$157.82	$177.34	$397.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.13 / $38.72 / $51.37	Professional	26	$28.13	$38.72	$51.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $129.69 / $138.61 / $346.19	Professional	TC	$129.69	$138.61	$346.19
HMSA Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $256.93 / $397.08	Professional		$46.04	$256.93	$397.08
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $48.85 / $51.15 / $52.44	Professional	26	$48.85	$51.15	$52.44
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $330.36 / $345.93 / $531.32	Professional	TC	$330.36	$345.93	$531.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $303.32 / $353.39 / $412.29	Professional		$303.32	$353.39	$412.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.19 / $45.66 / $53.27	Professional	26	$39.19	$45.66	$53.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $264.13 / $307.73 / $320.55	Professional	TC	$264.13	$307.73	$320.55
United Facility/Professional Professional Modifier Low / Median / High Price $241.92 / $397.56 / $479.84	Professional		$241.92	$397.56	$479.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.85 / $51.37 / $60.23	Professional	26	$43.85	$51.37	$60.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.07 / $346.19 / $419.61	Professional	TC	$198.07	$346.19	$419.61
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $226.04 / $373.95 / $747.04	Professional		$226.04	$373.95	$747.04
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $37.86 / $55.93 / $88.96	Professional	26	$37.86	$55.93	$88.96
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $188.17 / $317.99 / $658.08	Professional	TC	$188.17	$317.99	$658.08