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 Facility Modifier TC Low / Median / High Price $35.18 / $39.88 / $46.91	Facility	TC	$35.18	$39.88	$46.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.67 / $48.66 / $79.50	Professional		$42.67	$48.66	$79.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $16.12 / $60.53	Professional	26	$14.49	$16.12	$60.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.17 / $34.53 / $58.83	Professional	TC	$28.17	$34.53	$58.83
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 Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.74 / $55.06 / $72.11	Professional		$50.74	$55.06	$72.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $18.95 / $20.92	Professional	26	$15.30	$18.95	$20.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.87 / $35.92 / $50.47	Professional	TC	$31.87	$35.92	$50.47
HMSA Facility/Professional Professional Modifier Low / Median / High Price $19.35 / $65.66 / $70.77	Professional		$19.35	$65.66	$70.77
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $21.22 / $22.22 / $22.77	Professional	26	$21.22	$22.22	$22.77
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $48.00 / $48.00	Professional	TC	$45.84	$48.00	$48.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.88 / $57.68 / $67.30	Professional		$52.88	$57.68	$67.30
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 $38.22 / $41.70 / $44.13	Professional	TC	$38.22	$41.70	$44.13
United Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $64.89 / $74.17	Professional		$24.18	$64.89	$74.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $18.00 / $23.03	Professional	26	$8.34	$18.00	$23.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $46.91 / $51.14	Professional	TC	$15.84	$46.91	$51.14
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $75.54 / $117.00	Professional		$50.58	$75.54	$117.00
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.32 / $21.12 / $36.94	Professional	26	$16.32	$21.12	$36.94
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $34.28 / $52.10 / $75.02	Professional	TC	$34.28	$52.10	$75.02