Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.07 / $44.28 / $54.26	Facility	26	$39.07	$44.28	$54.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.99 / $79.34 / $142.41	Professional		$60.99	$79.34	$142.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.85 / $41.99 / $67.93	Professional	26	$36.85	$41.99	$67.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.15 / $37.36 / $74.48	Professional	TC	$24.15	$37.36	$74.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $92.98 / $113.95	Professional		$75.81	$92.98	$113.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.28 / $54.36 / $57.28	Professional	26	$44.28	$54.36	$57.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.28 / $48.71 / $59.69	Professional	TC	$19.28	$48.71	$59.69
HMSA Facility/Professional Professional Modifier Low / Median / High Price $53.20 / $67.84 / $141.72	Professional		$53.20	$67.84	$141.72
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $57.55 / $60.26 / $61.77	Professional	26	$57.55	$60.26	$61.77
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $55.71 / $76.34 / $79.95	Professional	TC	$55.71	$76.34	$79.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.28 / $109.39 / $127.62	Professional		$100.28	$109.39	$127.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.75 / $52.09 / $60.77	Professional	26	$47.75	$52.09	$60.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.53 / $57.30 / $66.84	Professional	TC	$52.53	$57.30	$66.84
United Facility/Professional Professional Modifier Low / Median / High Price $87.32 / $109.63 / $142.68	Professional		$87.32	$109.63	$142.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.28 / $54.26 / $72.36	Professional	26	$44.28	$54.26	$72.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.11 / $51.57 / $70.31	Professional	TC	$41.11	$51.57	$70.31
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $66.75 / $104.52 / $123.34	Professional		$66.75	$104.52	$123.34
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $32.92 / $52.75 / $58.32	Professional	26	$32.92	$52.75	$58.32
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $16.62 / $51.77 / $65.04	Professional	TC	$16.62	$51.77	$65.04