Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.36 / $10.61 / $12.49	Facility	26	$9.36	$10.61	$12.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $65.34 / $171.00	Professional		$27.27	$65.34	$171.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $12.94 / $32.67	Professional	26	$9.36	$12.94	$32.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $63.97 / $70.37	Professional	TC	$30.45	$63.97	$70.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.15 / $56.25 / $145.97	Professional		$29.15	$56.25	$145.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $11.82 / $13.59	Professional	26	$10.61	$11.82	$13.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.96 / $48.16 / $134.40	Professional	TC	$15.96	$48.16	$134.40
HMSA Facility/Professional Professional Modifier Low / Median / High Price $12.32 / $65.52 / $76.39	Professional		$12.32	$65.52	$76.39
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $12.19 / $13.84 / $14.49	Professional	26	$12.19	$13.84	$14.49
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $53.33 / $55.84 / $55.84	Professional	TC	$53.33	$55.84	$55.84
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $32.72 / $38.18	Professional		$30.00	$32.72	$38.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $11.10 / $12.95	Professional	26	$10.18	$11.10	$12.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $21.62 / $22.89	Professional	TC	$19.82	$21.62	$22.89
United Facility/Professional Professional Modifier Low / Median / High Price $13.35 / $36.81 / $58.00	Professional		$13.35	$36.81	$58.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.97 / $12.49 / $15.57	Professional	26	$5.97	$12.49	$15.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $7.38 / $22.65 / $30.26	Professional	TC	$7.38	$22.65	$30.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $62.50 / $214.08	Professional		$33.11	$62.50	$214.08
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $14.56 / $23.74	Professional	26	$10.85	$14.56	$23.74
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $20.46 / $37.24 / $196.25	Professional	TC	$20.46	$37.24	$196.25