Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.52 / $26.66 / $31.36	Facility	26	$23.52	$26.66	$31.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $85.94 / $475.00	Professional		$71.00	$85.94	$475.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $32.45 / $98.32	Professional	26	$16.92	$32.45	$98.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $56.82 / $70.76	Professional	TC	$28.10	$56.82	$70.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.69 / $71.23 / $152.24	Professional		$38.69	$71.23	$152.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $26.66 / $53.19	Professional	26	$18.76	$26.66	$53.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.93 / $39.88 / $108.83	Professional	TC	$19.93	$39.88	$108.83
HMSA Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $128.74 / $141.29	Professional		$28.10	$128.74	$141.29
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $30.10 / $31.52 / $32.29	Professional	26	$30.10	$31.52	$32.29
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $98.64 / $103.29 / $103.29	Professional	TC	$98.64	$103.29	$103.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $58.05 / $63.32 / $73.88	Professional		$58.05	$63.32	$73.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $27.88 / $32.52	Professional	26	$25.55	$27.88	$32.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.49 / $35.45 / $41.36	Professional	TC	$32.49	$35.45	$41.36
United Facility/Professional Professional Modifier Low / Median / High Price $53.43 / $71.23 / $80.30	Professional		$53.43	$71.23	$80.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $31.36 / $39.08	Professional	26	$23.52	$31.36	$39.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.27 / $39.88 / $41.22	Professional	TC	$28.27	$39.88	$41.22
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $65.01 / $92.37 / $152.72	Professional		$65.01	$92.37	$152.72
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $32.83 / $60.05	Professional	26	$18.41	$32.83	$60.05
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $35.49 / $60.86 / $119.89	Professional	TC	$35.49	$60.86	$119.89