Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.65 / $38.14 / $44.87	Facility	26	$33.65	$38.14	$44.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $151.88 / $729.24	Professional		$62.40	$151.88	$729.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.12 / $90.60 / $791.37	Professional	26	$30.12	$90.60	$791.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.34 / $82.69 / $152.69	Professional	TC	$35.34	$82.69	$152.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $87.90 / $96.30	Professional		$56.54	$87.90	$96.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $34.36 / $44.87	Professional	26	$25.09	$34.36	$44.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.45 / $51.42 / $53.54	Professional	TC	$31.45	$51.42	$53.54
HMSA Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $97.29 / $115.07	Professional		$39.56	$97.29	$115.07
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $41.97 / $43.95 / $45.05	Professional	26	$41.97	$43.95	$45.05
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $67.92 / $71.12 / $71.12	Professional	TC	$67.92	$71.12	$71.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.47 / $85.60 / $99.86	Professional		$73.47	$85.60	$99.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.24 / $39.89 / $46.54	Professional	26	$34.24	$39.89	$46.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $45.71 / $47.61	Professional	TC	$39.22	$45.71	$47.61
United Facility/Professional Professional Modifier Low / Median / High Price $96.30 / $99.03 / $110.99	Professional		$96.30	$99.03	$110.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.44 / $44.87 / $52.43	Professional	26	$38.44	$44.87	$52.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.42 / $58.56 / $60.59	Professional	TC	$51.42	$58.56	$60.59
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $79.16 / $108.77 / $174.66	Professional		$79.16	$108.77	$174.66
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $33.71 / $49.25 / $78.52	Professional	26	$33.71	$49.25	$78.52
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $45.45 / $61.73 / $99.12	Professional	TC	$45.45	$61.73	$99.12