Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.34 / $16.25 / $19.12	Facility	26	$14.34	$16.25	$19.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.68 / $72.56 / $93.94	Professional		$60.68	$72.56	$93.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $19.12 / $21.84	Professional	26	$15.71	$19.12	$21.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.99 / $55.17 / $89.71	Professional	TC	$44.99	$55.17	$89.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.02 / $65.34 / $98.98	Professional		$42.02	$65.34	$98.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.25 / $20.17 / $22.24	Professional	26	$16.25	$20.17	$22.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.08 / $53.52 / $73.36	Professional	TC	$43.08	$53.52	$73.36
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.45 / $27.67 / $91.23	Professional		$20.45	$27.67	$91.23
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $23.48 / $24.06	Professional	26	$22.42	$23.48	$24.06
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $68.81 / $72.05 / $72.05	Professional	TC	$68.81	$72.05	$72.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $80.53 / $93.95	Professional		$73.81	$80.53	$93.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.58 / $16.98 / $19.82	Professional	26	$15.58	$16.98	$19.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $63.55 / $67.26	Professional	TC	$58.26	$63.55	$67.26
United Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $90.60 / $100.64	Professional		$32.40	$90.60	$100.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $19.12 / $24.12	Professional	26	$8.75	$19.12	$24.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $57.92 / $76.52	Professional	TC	$23.65	$57.92	$76.52
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $71.76 / $98.59 / $135.97	Professional		$71.76	$98.59	$135.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.51 / $24.26 / $38.38	Professional	26	$17.51	$24.26	$38.38
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $51.71 / $77.84 / $100.14	Professional	TC	$51.71	$77.84	$100.14