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 $51.49 / $60.35 / $219.02	Professional		$51.49	$60.35	$219.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.36 / $20.05 / $45.90	Professional	26	$14.36	$20.05	$45.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.11 / $43.83 / $88.45	Professional	TC	$37.11	$43.83	$88.45
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 $61.92 / $73.36 / $90.53	Professional		$61.92	$73.36	$90.53
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 $43.45 / $52.22 / $70.48	Professional	TC	$43.45	$52.22	$70.48
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $77.30 / $95.02	Professional		$18.89	$77.30	$95.02
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 $66.88 / $70.03 / $72.79	Professional	TC	$66.88	$70.03	$72.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $73.77 / $80.47 / $93.88	Professional		$73.77	$80.47	$93.88
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 $57.43 / $62.65 / $66.31	Professional	TC	$57.43	$62.65	$66.31
United Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $90.53 / $99.95	Professional		$32.22	$90.53	$99.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.15 / $20.05 / $25.28	Professional	26	$9.15	$20.05	$25.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $70.48 / $74.67	Professional	TC	$23.08	$70.48	$74.67
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $83.10 / $107.82 / $156.31	Professional		$83.10	$107.82	$156.31
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $23.26 / $41.12	Professional	26	$18.36	$23.26	$41.12
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $64.70 / $79.48 / $114.71	Professional	TC	$64.70	$79.48	$114.71