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 $40.74 / $61.66 / $251.19	Professional		$40.74	$61.66	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $17.38 / $74.13	Professional	26	$10.96	$17.38	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $41.69 / $81.28	Professional	TC	$25.70	$41.69	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $102.33	Professional		$43.65	$66.07	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $33.11	Professional	26	$12.88	$17.38	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $46.77 / $69.18	Professional	TC	$30.20	$46.77	$69.18
HMSA Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $79.43	Professional		$57.54	$75.86	$79.43
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $20.42 / $21.38	Professional	26	$19.95	$20.42	$21.38
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $56.23 / $58.88	Professional	TC	$56.23	$56.23	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $83.18	Professional		$64.57	$70.79	$83.18
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 $51.29 / $54.95 / $64.57	Professional	TC	$51.29	$54.95	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $97.72	Professional		$60.26	$72.44	$97.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.62 / $25.12	Professional	26	$14.45	$18.62	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $51.29 / $70.79	Professional	TC	$46.77	$51.29	$70.79
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $114.82	Professional		$58.88	$83.18	$114.82
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $19.50 / $33.11	Professional	26	$15.49	$19.50	$33.11
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $64.57 / $85.11	Professional	TC	$41.69	$64.57	$85.11