Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $14.45 / $16.98	Facility	26	$12.88	$14.45	$16.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $47.86 / $229.09	Professional		$17.78	$47.86	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.79 / $57.54	Professional	26	$10.00	$14.79	$57.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.90 / $66.07	Professional	TC	$19.05	$30.90	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $47.86 / $81.28	Professional		$33.88	$47.86	$81.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.22 / $28.84	Professional	26	$10.47	$16.22	$28.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $51.29	Professional	TC	$22.91	$31.62	$51.29
HMSA Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $57.54 / $61.66	Professional		$43.65	$57.54	$61.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $16.98 / $17.78	Professional	26	$16.60	$16.98	$17.78
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $42.66 / $44.67	Professional	TC	$42.66	$42.66	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $54.95 / $64.57	Professional		$51.29	$54.95	$64.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $15.49 / $18.20	Professional	26	$14.13	$15.49	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $39.81 / $46.77	Professional	TC	$36.31	$39.81	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $53.70 / $83.18	Professional		$48.98	$53.70	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.98 / $25.70	Professional	26	$14.79	$16.98	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $34.67 / $54.95	Professional	TC	$33.11	$34.67	$54.95
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $85.11	Professional		$41.69	$66.07	$85.11
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.05 / $28.84	Professional	26	$12.59	$19.05	$28.84
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $47.86 / $58.88	Professional	TC	$29.51	$47.86	$58.88