Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.49 / $42.48 / $52.06	Facility	26	$37.49	$42.48	$52.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $145.34 / $164.74 / $314.82	Professional		$145.34	$164.74	$314.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.51 / $52.49 / $102.85	Professional	26	$48.51	$52.49	$102.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $112.25 / $250.03	Professional	TC	$96.82	$112.25	$250.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.61 / $236.50 / $236.50	Professional		$99.61	$236.50	$236.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.19 / $52.06 / $52.06	Professional	26	$30.19	$52.06	$52.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.42 / $184.43 / $184.43	Professional	TC	$69.42	$184.43	$184.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $114.81 / $243.59	Professional		$65.73	$114.81	$243.59
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $68.05 / $71.26 / $121.45	Professional	26	$68.05	$71.26	$121.45
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $162.00 / $169.63 / $185.04	Professional	TC	$162.00	$169.63	$185.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.12 / $227.04 / $264.88	Professional		$208.12	$227.04	$264.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.82 / $49.98 / $58.31	Professional	26	$45.82	$49.98	$58.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.29 / $177.05 / $206.56	Professional	TC	$162.29	$177.05	$206.56
United Facility/Professional Professional Modifier Low / Median / High Price $189.19 / $236.50 / $308.20	Professional		$189.19	$236.50	$308.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.06 / $71.54 / $73.41	Professional	26	$52.06	$71.54	$73.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $115.78 / $184.43 / $236.66	Professional	TC	$115.78	$184.43	$236.66
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $124.29 / $240.90 / $359.17	Professional		$124.29	$240.90	$359.17
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $50.92 / $63.56 / $108.34	Professional	26	$50.92	$63.56	$108.34
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $56.60 / $167.39 / $274.73	Professional	TC	$56.60	$167.39	$274.73