Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.45 / $34.51 / $42.29	Facility	26	$30.45	$34.51	$42.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $69.34 / $180.38	Professional		$48.25	$69.34	$180.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.14 / $34.82 / $52.98	Professional	26	$28.14	$34.82	$52.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.11 / $34.52 / $117.35	Professional	TC	$20.11	$34.52	$117.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.63 / $86.72 / $136.36	Professional		$61.63	$86.72	$136.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.51 / $42.45 / $44.30	Professional	26	$34.51	$42.45	$44.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $43.78 / $94.08	Professional	TC	$17.32	$43.78	$94.08
HMSA Facility/Professional Professional Modifier Low / Median / High Price $38.96 / $84.54 / $143.26	Professional		$38.96	$84.54	$143.26
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $42.70 / $44.71 / $45.83	Professional	26	$42.70	$44.71	$45.83
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $88.52 / $93.04 / $97.42	Professional	TC	$88.52	$93.04	$97.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $130.91 / $152.72	Professional		$120.00	$130.91	$152.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.21 / $40.60 / $47.36	Professional	26	$37.21	$40.60	$47.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $82.79 / $90.31 / $105.36	Professional	TC	$82.79	$90.31	$105.36
United Facility/Professional Professional Modifier Low / Median / High Price $90.61 / $120.00 / $158.79	Professional		$90.61	$120.00	$158.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.51 / $42.29 / $55.65	Professional	26	$34.51	$42.29	$55.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.27 / $86.40 / $103.14	Professional	TC	$60.27	$86.40	$103.14
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.62 / $104.02 / $151.75	Professional		$52.62	$104.02	$151.75
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $38.85 / $45.02	Professional	26	$25.42	$38.85	$45.02
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $15.33 / $73.16 / $106.73	Professional	TC	$15.33	$73.16	$106.73