Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.23 / $79.59 / $97.55	Facility	26	$70.23	$79.59	$97.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.13 / $161.07 / $225.66	Professional		$131.13	$161.07	$225.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.89 / $82.73 / $122.11	Professional	26	$65.89	$82.73	$122.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.07 / $64.42 / $95.34	Professional	TC	$52.07	$64.42	$95.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.96 / $184.38 / $191.19	Professional		$141.96	$184.38	$191.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.59 / $97.69 / $102.50	Professional	26	$79.59	$97.69	$102.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.35 / $87.01 / $88.69	Professional	TC	$62.35	$87.01	$88.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $75.88 / $103.73 / $193.59	Professional		$75.88	$103.73	$193.59
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $97.20 / $101.78 / $104.32	Professional	26	$97.20	$101.78	$104.32
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $85.25 / $89.27 / $89.27	Professional	TC	$85.25	$89.27	$89.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.10 / $167.02 / $194.85	Professional		$153.10	$167.02	$194.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.84 / $93.65 / $109.26	Professional	26	$85.84	$93.65	$109.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.23 / $73.36 / $85.58	Professional	TC	$67.23	$73.36	$85.58
United Facility/Professional Professional Modifier Low / Median / High Price $141.96 / $150.31 / $242.06	Professional		$141.96	$150.31	$242.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.59 / $97.55 / $129.62	Professional	26	$79.59	$97.55	$129.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.35 / $76.41 / $112.44	Professional	TC	$62.35	$76.41	$112.44
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $112.96 / $173.42 / $200.10	Professional		$112.96	$173.42	$200.10
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $60.49 / $92.39 / $107.15	Professional	26	$60.49	$92.39	$107.15
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $52.47 / $81.03 / $92.95	Professional	TC	$52.47	$81.03	$92.95