Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.99 / $16.98 / $19.98	Facility	26	$14.99	$16.98	$19.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.15 / $66.08 / $72.19	Professional		$55.15	$66.08	$72.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $15.11 / $51.94	Professional	26	$13.58	$15.11	$51.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.56 / $49.37 / $51.77	Professional	TC	$41.56	$49.37	$51.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.36 / $17.36 / $17.36	Facility	26	$17.36	$17.36	$17.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.09 / $59.82 / $79.92	Professional		$43.09	$59.82	$79.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $18.20 / $21.44	Professional	26	$16.98	$18.20	$21.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $42.09 / $58.47	Professional	TC	$29.34	$42.09	$58.47
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.39 / $80.12 / $88.63	Professional		$18.39	$80.12	$88.63
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $20.16 / $21.11 / $21.64	Professional	26	$20.16	$21.11	$21.64
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $61.87 / $64.79 / $64.79	Professional	TC	$61.87	$64.79	$64.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.37 / $52.76 / $61.56	Professional		$48.37	$52.76	$61.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.28 / $17.76 / $20.72	Professional	26	$16.28	$17.76	$20.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.09 / $35.00 / $37.04	Professional	TC	$32.09	$35.00	$37.04
United Facility/Professional Professional Modifier Low / Median / High Price $22.15 / $59.36 / $67.05	Professional		$22.15	$59.36	$67.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.17 / $19.98 / $25.20	Professional	26	$9.17	$19.98	$25.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $12.98 / $39.38 / $41.85	Professional	TC	$12.98	$39.38	$41.85
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $54.02 / $74.16 / $140.77	Professional		$54.02	$74.16	$140.77
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $14.92 / $22.87 / $38.92	Professional	26	$14.92	$22.87	$38.92
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $36.17 / $48.78 / $112.79	Professional	TC	$36.17	$48.78	$112.79