Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $15.30 / $18.00	Facility	26	$13.50	$15.30	$18.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.97 / $47.62 / $85.17	Professional		$39.97	$47.62	$85.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.10 / $13.48 / $20.68	Professional	26	$12.10	$13.48	$20.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $34.14 / $64.50	Professional	TC	$27.87	$34.14	$64.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.82 / $53.47 / $69.47	Professional		$46.82	$53.47	$69.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $15.59 / $19.55	Professional	26	$15.30	$15.59	$19.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.41 / $36.45 / $51.42	Professional	TC	$31.41	$36.45	$51.42
HMSA Facility/Professional Professional Modifier Low / Median / High Price $16.97 / $57.28 / $71.25	Professional		$16.97	$57.28	$71.25
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $17.57 / $18.39 / $18.86	Professional	26	$17.57	$18.39	$18.86
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $50.47 / $52.85 / $52.85	Professional	TC	$50.47	$52.85	$52.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $61.70 / $71.98	Professional		$56.56	$61.70	$71.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.66 / $16.00 / $18.66	Professional	26	$14.66	$16.00	$18.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $41.90 / $45.71 / $48.37	Professional	TC	$41.90	$45.71	$48.37
United Facility/Professional Professional Modifier Low / Median / High Price $25.51 / $69.42 / $78.50	Professional		$25.51	$69.42	$78.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.15 / $18.00 / $22.41	Professional	26	$8.15	$18.00	$22.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.36 / $51.42 / $56.09	Professional	TC	$17.36	$51.42	$56.09
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.38 / $75.53 / $109.62	Professional		$47.38	$75.53	$109.62
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $13.27 / $20.07 / $35.10	Professional	26	$13.27	$20.07	$35.10
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $55.99 / $74.52	Professional	TC	$35.15	$55.99	$74.52