Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.29 / $53.60 / $63.06	Facility	26	$47.29	$53.60	$63.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $63.82 / $232.20	Professional		$43.86	$63.82	$232.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.95 / $42.29 / $99.20	Professional	26	$30.95	$42.29	$99.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.91 / $21.53 / $36.13	Professional	TC	$12.91	$21.53	$36.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $67.95 / $91.89	Professional		$51.30	$67.95	$91.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $48.13 / $63.06	Professional	26	$35.11	$48.13	$63.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.18 / $19.80 / $28.85	Professional	TC	$16.18	$19.80	$28.85
HMSA Facility/Professional Professional Modifier Low / Median / High Price $24.83 / $36.44 / $89.36	Professional		$24.83	$36.44	$89.36
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $58.99 / $61.77 / $63.32	Professional	26	$58.99	$61.77	$63.32
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $27.59 / $27.59	Professional	TC	$26.35	$27.59	$27.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.11 / $81.68 / $95.30	Professional		$70.11	$81.68	$95.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.11 / $56.05 / $65.39	Professional	26	$48.11	$56.05	$65.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $25.64 / $26.71	Professional	TC	$22.01	$25.64	$26.71
United Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $91.89 / $106.37	Professional		$79.81	$91.89	$106.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $63.06 / $73.81	Professional	26	$53.70	$63.06	$73.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.12 / $32.54 / $32.54	Professional	TC	$26.12	$32.54	$32.54
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $100.02 / $161.94	Professional		$70.48	$100.02	$161.94
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $68.48 / $110.19	Professional	26	$47.22	$68.48	$110.19
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $22.67 / $31.41 / $51.75	Professional	TC	$22.67	$31.41	$51.75