Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.16 / $14.92 / $17.55	Facility	26	$13.16	$14.92	$17.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $77.97 / $236.00	Professional		$47.71	$77.97	$236.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.61 / $20.18 / $45.62	Professional	26	$13.61	$20.18	$45.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $42.47 / $69.81	Professional	TC	$34.09	$42.47	$69.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.94 / $52.97 / $79.02	Professional		$32.94	$52.97	$79.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $17.23 / $19.50	Professional	26	$14.92	$17.23	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $44.45 / $61.45	Professional	TC	$33.11	$44.45	$61.45
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $24.35 / $77.44	Professional		$17.98	$24.35	$77.44
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $20.66 / $21.17	Professional	26	$19.73	$20.66	$21.17
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $57.71 / $60.43 / $60.43	Professional	TC	$57.71	$60.43	$60.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.38 / $70.23 / $81.94	Professional		$64.38	$70.23	$81.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $15.60 / $18.20	Professional	26	$14.30	$15.60	$18.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.07 / $54.62 / $57.81	Professional	TC	$50.07	$54.62	$57.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.59 / $79.02 / $85.38	Professional		$27.59	$79.02	$85.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $22.99 / $100.00	Professional	26	$13.96	$22.99	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $61.45 / $63.51	Professional	TC	$19.64	$61.45	$63.51
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $85.98 / $107.98	Professional		$57.11	$85.98	$107.98
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.05 / $21.25 / $33.11	Professional	26	$15.05	$21.25	$33.11
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $41.14 / $65.59 / $78.31	Professional	TC	$41.14	$65.59	$78.31