Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.89 / $16.88 / $19.86	Facility	26	$14.89	$16.88	$19.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $70.68 / $107.79	Professional		$61.75	$70.68	$107.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.99 / $42.45	Professional	26	$7.33	$10.99	$42.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.52 / $63.35 / $78.90	Professional	TC	$52.52	$63.35	$78.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.93 / $16.93 / $16.93	Facility	26	$16.93	$16.93	$16.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.57 / $61.66 / $99.05	Professional		$52.57	$61.66	$99.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $10.17 / $19.86	Professional	26	$9.27	$10.17	$19.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.61 / $52.38 / $81.43	Professional	TC	$35.61	$52.38	$81.43
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $104.68 / $122.38	Professional		$17.55	$104.68	$122.38
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $19.23 / $20.14 / $20.66	Professional	26	$19.23	$20.14	$20.66
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $85.44 / $89.47 / $89.47	Professional	TC	$85.44	$89.47	$89.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.31 / $54.89 / $64.04	Professional		$50.31	$54.89	$64.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $17.64 / $20.59	Professional	26	$16.18	$17.64	$20.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.13 / $37.24 / $39.40	Professional	TC	$34.13	$37.24	$39.40
United Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $61.75 / $69.76	Professional		$23.13	$61.75	$69.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.01 / $19.86 / $24.20	Professional	26	$9.01	$19.86	$24.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.12 / $41.89 / $56.35	Professional	TC	$14.12	$41.89	$56.35
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $79.50 / $164.17	Professional		$41.17	$79.50	$164.17
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $15.10 / $23.18	Professional	26	$9.35	$15.10	$23.18
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $71.58 / $155.72	Professional	TC	$39.25	$71.58	$155.72