Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.22 / $44.46 / $54.49	Facility	26	$39.22	$44.46	$54.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.69 / $148.08 / $196.63	Professional		$100.69	$148.08	$196.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.65 / $43.04 / $68.28	Professional	26	$37.65	$43.04	$68.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.03 / $105.16 / $132.30	Professional	TC	$63.03	$105.16	$132.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.43 / $136.19 / $197.71	Professional		$128.43	$136.19	$197.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.46 / $54.71 / $59.35	Professional	26	$44.46	$54.71	$59.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.84 / $83.97 / $139.03	Professional	TC	$76.84	$83.97	$139.03
HMSA Facility/Professional Professional Modifier Low / Median / High Price $56.03 / $156.81 / $213.53	Professional		$56.03	$156.81	$213.53
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $60.00 / $62.83 / $64.40	Professional	26	$60.00	$62.83	$64.40
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $126.15 / $142.41 / $149.13	Professional	TC	$126.15	$142.41	$149.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.50 / $151.09 / $176.27	Professional		$138.50	$151.09	$176.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.95 / $52.31 / $61.03	Professional	26	$47.95	$52.31	$61.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.55 / $98.78 / $115.25	Professional	TC	$90.55	$98.78	$115.25
United Facility/Professional Professional Modifier Low / Median / High Price $128.43 / $135.97 / $217.08	Professional		$128.43	$135.97	$217.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.46 / $54.49 / $73.05	Professional	26	$44.46	$54.49	$73.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.97 / $102.47 / $144.03	Professional	TC	$83.97	$102.47	$144.03
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $100.37 / $163.44 / $201.52	Professional		$100.37	$163.44	$201.52
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.92 / $53.61 / $58.32	Professional	26	$32.92	$53.61	$58.32
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $109.84 / $147.60	Professional	TC	$67.45	$109.84	$147.60