Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.04 / $17.04 / $20.05	Facility	26	$15.04	$17.04	$20.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $73.29 / $249.44	Professional		$56.75	$73.29	$249.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $20.77 / $33.86	Professional	26	$14.36	$20.77	$33.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $50.05 / $104.21	Professional	TC	$42.39	$50.05	$104.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $74.73 / $103.09	Professional		$40.88	$74.73	$103.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.04 / $18.47 / $22.28	Professional	26	$17.04	$18.47	$22.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.62 / $62.15 / $83.04	Professional	TC	$49.62	$62.15	$83.04
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $25.56 / $99.34	Professional		$18.89	$25.56	$99.34
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $21.23 / $22.23	Professional	26	$19.92	$21.23	$22.23
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $79.42 / $83.16 / $86.44	Professional	TC	$79.42	$83.16	$86.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $91.63 / $106.90	Professional		$84.00	$91.63	$106.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $17.82 / $20.79	Professional	26	$16.34	$17.82	$20.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.66 / $73.81 / $78.12	Professional	TC	$67.66	$73.81	$78.12
United Facility/Professional Professional Modifier Low / Median / High Price $36.84 / $94.64 / $114.55	Professional		$36.84	$94.64	$114.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $20.05 / $25.64	Professional	26	$9.36	$20.05	$25.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.47 / $67.34 / $88.91	Professional	TC	$27.47	$67.34	$88.91
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $94.64 / $117.67 / $161.97	Professional		$94.64	$117.67	$161.97
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $24.96 / $39.04	Professional	26	$18.89	$24.96	$39.04
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $76.27 / $92.20 / $122.91	Professional	TC	$76.27	$92.20	$122.91