Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.34 / $15.12 / $17.79	Facility	26	$13.34	$15.12	$17.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $65.77 / $75.05	Professional		$46.93	$65.77	$75.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $14.74 / $19.88	Professional	26	$12.78	$14.74	$19.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.14 / $40.33 / $89.08	Professional	TC	$34.14	$40.33	$89.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $61.84 / $88.79	Professional		$24.55	$61.84	$88.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.12 / $16.47 / $19.77	Professional	26	$15.12	$16.47	$19.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.97 / $50.11 / $71.00	Professional	TC	$39.97	$50.11	$71.00
HMSA Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $71.15 / $91.50	Professional		$16.80	$71.15	$91.50
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $17.71 / $18.87 / $19.76	Professional	26	$17.71	$18.87	$19.76
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $65.92 / $69.03 / $71.73	Professional	TC	$65.92	$69.03	$71.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.34 / $78.92 / $92.08	Professional		$72.34	$78.92	$92.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.50 / $15.82 / $18.45	Professional	26	$14.50	$15.82	$18.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.85 / $63.11 / $66.79	Professional	TC	$57.85	$63.11	$66.79
United Facility/Professional Professional Modifier Low / Median / High Price $30.45 / $88.79 / $94.67	Professional		$30.45	$88.79	$94.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $17.79 / $21.87	Professional	26	$7.94	$17.79	$21.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.51 / $71.00 / $72.80	Professional	TC	$22.51	$71.00	$72.80
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $81.52 / $98.67 / $142.61	Professional		$81.52	$98.67	$142.61
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $20.61 / $35.99	Professional	26	$16.30	$20.61	$35.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $77.70 / $105.52	Professional	TC	$63.10	$77.70	$105.52