Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.71 / $16.67 / $19.62	Facility	26	$14.71	$16.67	$19.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.39 / $82.79 / $110.30	Professional		$67.39	$82.79	$110.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $18.98 / $21.80	Professional	26	$16.17	$18.98	$21.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.21 / $62.80 / $87.82	Professional	TC	$51.21	$62.80	$87.82
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 $67.66 / $73.73 / $99.56	Professional		$67.66	$73.73	$99.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $20.17 / $22.67	Professional	26	$16.67	$20.17	$22.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.49 / $53.52 / $77.76	Professional	TC	$47.49	$53.52	$77.76
HMSA Facility/Professional Professional Modifier Low / Median / High Price $20.80 / $88.00 / $96.02	Professional		$20.80	$88.00	$96.02
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $22.80 / $23.87 / $24.47	Professional	26	$22.80	$23.87	$24.47
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $68.33 / $71.55 / $71.55	Professional	TC	$68.33	$71.55	$71.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.01 / $79.64 / $92.92	Professional		$73.01	$79.64	$92.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $17.44 / $20.34	Professional	26	$15.98	$17.44	$20.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.02 / $62.21 / $65.84	Professional	TC	$57.02	$62.21	$65.84
United Facility/Professional Professional Modifier Low / Median / High Price $32.40 / $89.60 / $100.64	Professional		$32.40	$89.60	$100.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $19.62 / $24.68	Professional	26	$8.75	$19.62	$24.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $69.98 / $76.52	Professional	TC	$23.65	$69.98	$76.52
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.59 / $100.64 / $145.05	Professional		$70.59	$100.64	$145.05
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.34 / $24.99 / $39.88	Professional	26	$16.34	$24.99	$39.88
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $54.26 / $76.20 / $110.94	Professional	TC	$54.26	$76.20	$110.94