Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.02 / $30.63 / $36.03	Facility	26	$27.02	$30.63	$36.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.92 / $88.15 / $99.31	Professional		$69.92	$88.15	$99.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $38.65 / $97.65	Professional	26	$23.46	$38.65	$97.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.96 / $58.79 / $58.79	Professional	52	$34.96	$58.79	$58.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.64 / $58.20 / $69.59	Professional	TC	$49.64	$58.20	$69.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.97 / $30.97 / $30.97	Facility	26	$30.97	$30.97	$30.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $82.78 / $215.20	Professional		$44.69	$82.78	$215.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.72 / $33.60 / $57.69	Professional	26	$21.72	$33.60	$57.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.97 / $51.56 / $125.44	Professional	TC	$22.97	$51.56	$125.44
HMSA Facility/Professional Professional Modifier Low / Median / High Price $31.95 / $95.95 / $115.88	Professional		$31.95	$95.95	$115.88
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $35.83 / $36.72	Professional	26	$34.22	$35.83	$36.72
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $68.88 / $72.13 / $79.16	Professional	TC	$68.88	$72.13	$79.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.17 / $73.27 / $85.48	Professional		$67.17	$73.27	$85.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.36 / $32.03 / $37.36	Professional	26	$29.36	$32.03	$37.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.81 / $41.24 / $48.12	Professional	TC	$37.81	$41.24	$48.12
United Facility/Professional Professional Modifier Low / Median / High Price $66.59 / $82.43 / $132.62	Professional		$66.59	$82.43	$132.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.83 / $36.03 / $45.57	Professional	26	$25.83	$36.03	$45.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.34 / $46.40 / $87.05	Professional	TC	$36.34	$46.40	$87.05
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $115.82 / $202.30	Professional		$75.33	$115.82	$202.30
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $40.18 / $65.14	Professional	26	$25.82	$40.18	$65.14
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $42.62 / $78.84 / $145.66	Professional	TC	$42.62	$78.84	$145.66