Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.36 / $17.41 / $20.48	Facility	26	$15.36	$17.41	$20.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $53.00 / $92.99	Professional		$47.68	$53.00	$92.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.82 / $23.44	Professional	26	$13.58	$15.82	$23.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $42.47 / $70.78	Professional	TC	$34.09	$42.47	$70.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.71 / $17.71 / $17.71	Facility	26	$17.71	$17.71	$17.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.31 / $63.23 / $84.36	Professional		$53.31	$63.23	$84.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.41 / $17.80 / $22.53	Professional	26	$17.41	$17.80	$22.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.61 / $42.29 / $61.59	Professional	TC	$35.61	$42.29	$61.59
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.09 / $65.66 / $78.70	Professional		$18.09	$65.66	$78.70
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $20.75 / $21.28	Professional	26	$19.82	$20.75	$21.28
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $53.85 / $56.39 / $57.42	Professional	TC	$53.85	$56.39	$57.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.86 / $67.48 / $78.73	Professional		$61.86	$67.48	$78.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.69 / $18.20 / $21.24	Professional	26	$16.69	$18.20	$21.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.17 / $49.27 / $52.15	Professional	TC	$45.17	$49.27	$52.15
United Facility/Professional Professional Modifier Low / Median / High Price $28.06 / $75.92 / $86.25	Professional		$28.06	$75.92	$86.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $20.48 / $25.83	Professional	26	$9.36	$20.48	$25.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $46.96 / $60.42	Professional	TC	$18.70	$46.96	$60.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $56.98 / $84.17 / $121.03	Professional		$56.98	$84.17	$121.03
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.30 / $22.89 / $39.88	Professional	26	$15.30	$22.89	$39.88
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.14 / $61.67 / $81.17	Professional	TC	$41.14	$61.67	$81.17