Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.77 / $12.21 / $14.36	Facility	26	$10.77	$12.21	$14.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.61 / $55.96 / $166.60	Professional		$46.61	$55.96	$166.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $11.11 / $47.38	Professional	26	$10.02	$11.11	$47.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.57 / $44.85 / $56.30	Professional	TC	$36.57	$44.85	$56.30
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $12.30	Facility	26	$12.30	$12.30	$12.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $49.12 / $65.84	Professional		$45.65	$49.12	$65.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.14 / $12.95 / $15.96	Professional	26	$12.14	$12.95	$15.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.70 / $35.92 / $49.89	Professional	TC	$32.70	$35.92	$49.89
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $60.14 / $65.66	Professional		$13.05	$60.14	$65.66
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.30 / $14.97 / $15.35	Professional	26	$14.30	$14.97	$15.35
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $48.00 / $48.00	Professional	TC	$45.84	$48.00	$48.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.29 / $52.68 / $61.46	Professional		$48.29	$52.68	$61.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $12.77 / $14.90	Professional	26	$11.70	$12.77	$14.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $36.59 / $39.90 / $42.24	Professional	TC	$36.59	$39.90	$42.24
United Facility/Professional Professional Modifier Low / Median / High Price $21.60 / $59.27 / $66.56	Professional		$21.60	$59.27	$66.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $14.36 / $17.91	Professional	26	$6.52	$14.36	$17.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.08 / $44.90 / $48.65	Professional	TC	$15.08	$44.90	$48.65
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $47.19 / $68.03 / $100.55	Professional		$47.19	$68.03	$100.55
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.43 / $16.30 / $27.28	Professional	26	$11.43	$16.30	$27.28
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $35.75 / $51.76 / $78.38	Professional	TC	$35.75	$51.76	$78.38