Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.29 / $19.60 / $23.06	Facility	26	$17.29	$19.60	$23.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $72.25 / $144.86	Professional		$61.64	$72.25	$144.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.61 / $17.34 / $26.57	Professional	26	$15.61	$17.34	$26.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.00 / $54.32 / $118.29	Professional	TC	$46.00	$54.32	$118.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.60 / $19.60 / $19.60	Facility	26	$19.60	$19.60	$19.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.00 / $89.74 / $117.37	Professional		$74.00	$89.74	$117.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.14 / $20.14 / $24.37	Professional	26	$19.14	$20.14	$24.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.87 / $67.48 / $94.31	Professional	TC	$53.87	$67.48	$94.31
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.48 / $27.70 / $110.20	Professional		$20.48	$27.70	$110.20
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $21.60 / $23.01 / $24.09	Professional	26	$21.60	$23.01	$24.09
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $88.60 / $92.77 / $96.43	Professional	TC	$88.60	$92.77	$96.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $95.63 / $104.33 / $121.72	Professional		$95.63	$104.33	$121.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.79 / $20.50 / $23.91	Professional	26	$18.79	$20.50	$23.91
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.84 / $83.83 / $88.72	Professional	TC	$76.84	$83.83	$88.72
United Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $117.37 / $133.44	Professional		$42.81	$117.37	$133.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $23.06 / $29.04	Professional	26	$10.58	$23.06	$29.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.22 / $94.31 / $104.40	Professional	TC	$32.22	$94.31	$104.40
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $107.76 / $131.97 / $195.64	Professional		$107.76	$131.97	$195.64
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $26.68 / $45.13	Professional	26	$21.12	$26.68	$45.13
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $86.63 / $105.30 / $151.38	Professional	TC	$86.63	$105.30	$151.38