Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $16.98 / $19.95	Facility	26	$14.79	$16.98	$19.95
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $41.69 / $46.77	Facility	TC	$34.67	$41.69	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $43.65 / $229.09	Professional		$32.36	$43.65	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.14 / $83.18	Professional	26	$12.02	$15.14	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $26.92 / $44.67	Professional	TC	$19.95	$26.92	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $89.13	Professional		$33.88	$56.23	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $19.95 / $33.88	Professional	26	$12.88	$19.95	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $34.67 / $53.70	Professional	TC	$20.89	$34.67	$53.70
HMSA Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $58.88 / $67.61	Professional		$22.91	$58.88	$67.61
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.50 / $20.42	Professional	26	$19.05	$19.50	$20.42
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $46.77	Professional	TC	$44.67	$44.67	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $58.88 / $69.18	Professional		$53.70	$58.88	$69.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $17.78 / $20.89	Professional	26	$16.60	$17.78	$20.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $41.69 / $47.86	Professional	TC	$38.02	$41.69	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $91.20	Professional		$53.70	$61.66	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $22.91 / $29.51	Professional	26	$16.60	$22.91	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $37.15 / $57.54	Professional	TC	$35.48	$37.15	$57.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $75.86 / $107.15	Professional		$63.10	$75.86	$107.15
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.91 / $39.81	Professional	26	$18.62	$22.91	$39.81
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $67.61	Professional	TC	$42.66	$52.48	$67.61