Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.48 / $32.28 / $37.97	Facility	26	$28.48	$32.28	$37.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $74.09 / $88.87	Professional		$50.14	$74.09	$88.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.85 / $39.59 / $99.43	Professional	26	$26.85	$39.59	$99.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $24.00 / $24.00 / $24.75	Professional	52	$24.00	$24.00	$24.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $27.08 / $45.38	Professional	TC	$23.57	$27.08	$45.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $65.36 / $80.34	Professional		$61.94	$65.36	$80.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.28 / $34.29 / $41.32	Professional	26	$32.28	$34.29	$41.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.64 / $30.71 / $39.02	Professional	TC	$27.64	$30.71	$39.02
HMSA Facility/Professional Professional Modifier Low / Median / High Price $30.85 / $48.50 / $73.97	Professional		$30.85	$48.50	$73.97
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $38.51 / $38.51	Professional	26	$36.78	$38.51	$38.51
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $33.86 / $35.46 / $35.46	Professional	TC	$33.86	$35.46	$35.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.38 / $65.87 / $76.84	Professional		$60.38	$65.87	$76.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.94 / $33.76 / $39.38	Professional	26	$30.94	$33.76	$39.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.44 / $32.11 / $33.99	Professional	TC	$29.44	$32.11	$33.99
United Facility/Professional Professional Modifier Low / Median / High Price $55.64 / $87.90 / $411.72	Professional		$55.64	$87.90	$411.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.34 / $37.97 / $47.34	Professional	26	$17.34	$37.97	$47.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.34 / $36.13 / $43.35	Professional	TC	$13.34	$36.13	$43.35
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $85.88 / $139.50	Professional		$67.95	$85.88	$139.50
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $34.78 / $45.00 / $72.13	Professional	26	$34.78	$45.00	$72.13
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $33.18 / $41.66 / $67.37	Professional	TC	$33.18	$41.66	$67.37