Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.02 / $14.76 / $17.36	Facility	26	$13.02	$14.76	$17.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.85 / $67.34 / $80.64	Professional		$34.85	$67.34	$80.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $17.36 / $18.94	Professional	26	$12.59	$17.36	$18.94
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.28 / $15.28 / $15.28	Professional	52	$15.28	$15.28	$15.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.26 / $27.26 / $60.72	Professional	TC	$22.26	$27.26	$60.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.96 / $14.96 / $14.96	Facility	26	$14.96	$14.96	$14.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $45.70 / $65.77	Professional		$40.88	$45.70	$65.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.74 / $15.15 / $19.29	Professional	26	$13.74	$15.15	$19.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.82 / $29.12 / $48.41	Professional	TC	$24.82	$29.12	$48.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $57.28 / $66.95	Professional		$15.85	$57.28	$66.95
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $18.20 / $18.64	Professional	26	$17.38	$18.20	$18.64
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.13 / $48.30 / $48.30	Professional	TC	$46.13	$48.30	$48.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $58.46 / $68.20	Professional		$53.59	$58.46	$68.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $15.43 / $18.00	Professional	26	$14.15	$15.43	$18.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.45 / $43.03 / $45.54	Professional	TC	$39.45	$43.03	$45.54
United Facility/Professional Professional Modifier Low / Median / High Price $24.17 / $65.77 / $74.05	Professional		$24.17	$65.77	$74.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.84 / $21.68 / $102.97	Professional	26	$13.84	$21.68	$102.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.61 / $52.37 / $222.24	Professional	TC	$30.61	$52.37	$222.24
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $72.62 / $92.23	Professional		$46.22	$72.62	$92.23
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $15.83 / $19.39 / $34.78	Professional	26	$15.83	$19.39	$34.78
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $31.01 / $52.71 / $60.69	Professional	TC	$31.01	$52.71	$60.69