Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $12.59 / $14.79	Facility	26	$11.22	$12.59	$14.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $52.48 / $346.74	Facility	TC	$40.74	$52.48	$346.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $60.26 / $218.78	Professional		$23.44	$60.26	$218.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.38 / $64.57	Professional	26	$8.91	$17.38	$64.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $204.17 / $549.54	Professional	50	$75.86	$204.17	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $75.86	Professional	TC	$23.99	$38.90	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $83.18	Professional		$34.67	$47.86	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $23.44	Professional	26	$9.77	$13.18	$23.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $33.11 / $60.26	Professional	TC	$24.55	$33.11	$60.26
HMSA Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $69.18 / $75.86	Professional		$48.98	$69.18	$75.86
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.79 / $15.49	Professional	26	$14.45	$14.79	$15.49
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $53.70 / $61.66	Professional	TC	$51.29	$53.70	$61.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $77.62	Professional		$60.26	$66.07	$77.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.80 / $15.85	Professional	26	$12.59	$13.80	$15.85
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $52.48 / $60.26	Professional	TC	$47.86	$52.48	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $89.13	Professional		$50.12	$57.54	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $14.79 / $22.39	Professional	26	$12.88	$14.79	$22.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $66.07	Professional	TC	$36.31	$42.66	$66.07
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $74.13 / $89.13	Professional		$46.77	$74.13	$89.13
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.22 / $23.99	Professional	26	$12.88	$16.22	$23.99
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $54.95 / $67.61	Professional	TC	$35.48	$54.95	$67.61