Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.92 / $46.37 / $54.55	Facility	26	$40.92	$46.37	$54.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $62.59 / $246.35	Professional		$52.52	$62.59	$246.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.87 / $40.58 / $63.35	Professional	26	$26.87	$40.58	$63.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $19.62 / $183.00	Professional	TC	$16.03	$19.62	$183.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.01 / $122.31 / $200.31	Professional		$45.01	$122.31	$200.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $46.50 / $54.55	Professional	26	$33.72	$46.50	$54.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.28 / $75.81 / $145.75	Professional	TC	$11.28	$75.81	$145.75
HMSA Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $138.40 / $203.99	Professional		$49.63	$138.40	$203.99
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $52.66 / $55.14 / $56.52	Professional	26	$52.66	$55.14	$56.52
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $142.15 / $148.85 / $161.37	Professional	TC	$142.15	$148.85	$161.37
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $152.83 / $178.06 / $207.73	Professional		$152.83	$178.06	$207.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $48.49 / $56.57	Professional	26	$41.62	$48.49	$56.57
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $111.20 / $129.55 / $134.94	Professional	TC	$111.20	$129.55	$134.94
United Facility/Professional Professional Modifier Low / Median / High Price $109.87 / $200.31 / $204.50	Professional		$109.87	$200.31	$204.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.73 / $54.55 / $63.57	Professional	26	$51.73	$54.55	$63.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.14 / $140.93 / $145.75	Professional	TC	$58.14	$140.93	$145.75
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $62.70 / $171.74 / $253.97	Professional		$62.70	$171.74	$253.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $45.29 / $59.98 / $94.99	Professional	26	$45.29	$59.98	$94.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $16.48 / $109.87 / $171.28	Professional	TC	$16.48	$109.87	$171.28