Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $16.22 / $19.05	Facility	26	$14.45	$16.22	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $74.13 / $323.59	Professional		$42.66	$74.13	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.05 / $91.20	Professional	26	$12.02	$19.05	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $50.12 / $81.28	Professional	TC	$30.20	$50.12	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $79.43 / $117.49	Professional		$58.88	$79.43	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $38.90	Professional	26	$15.14	$20.42	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $57.54 / $79.43	Professional	TC	$41.69	$57.54	$79.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $95.50	Professional		$64.57	$95.50	$95.50
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $22.91 / $23.99	Professional	26	$22.39	$22.91	$23.99
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $69.18 / $72.44	Professional	TC	$69.18	$69.18	$72.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $97.72	Professional		$75.86	$83.18	$97.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $17.38 / $20.42	Professional	26	$16.22	$17.38	$20.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $66.07 / $77.62	Professional	TC	$60.26	$66.07	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $120.23	Professional		$72.44	$85.11	$120.23
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 $54.95 / $61.66 / $89.13	Professional	TC	$54.95	$61.66	$89.13
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $138.04	Professional		$74.13	$100.00	$138.04
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $22.39 / $38.02	Professional	26	$17.78	$22.39	$38.02
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $77.62 / $102.33	Professional	TC	$51.29	$77.62	$102.33