Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.80 / $23.57 / $27.73	Facility	26	$20.80	$23.57	$27.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.02 / $99.24 / $115.81	Professional		$63.02	$99.24	$115.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.46 / $19.57 / $31.76	Professional	26	$14.46	$19.57	$31.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $43.42 / $84.04	Professional	TC	$29.25	$43.42	$84.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.08 / $78.42 / $105.23	Professional		$65.08	$78.42	$105.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.99 / $25.38 / $30.81	Professional	26	$22.99	$25.38	$30.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.09 / $49.63 / $74.42	Professional	TC	$42.09	$49.63	$74.42
HMSA Facility/Professional Professional Modifier Low / Median / High Price $25.40 / $71.47 / $97.89	Professional		$25.40	$71.47	$97.89
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $27.84 / $29.15 / $29.88	Professional	26	$27.84	$29.15	$29.88
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $63.99 / $69.34 / $72.62	Professional	TC	$63.99	$69.34	$72.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $77.17 / $84.18 / $98.21	Professional		$77.17	$84.18	$98.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $24.65 / $28.76	Professional	26	$22.59	$24.65	$28.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $54.57 / $59.53 / $63.00	Professional	TC	$54.57	$59.53	$63.00
United Facility/Professional Professional Modifier Low / Median / High Price $34.78 / $94.70 / $106.14	Professional		$34.78	$94.70	$106.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $27.73 / $35.19	Professional	26	$12.84	$27.73	$35.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $66.97 / $70.95	Professional	TC	$21.94	$66.97	$70.95
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $83.88 / $104.78 / $165.53	Professional		$83.88	$104.78	$165.53
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $24.20 / $31.02 / $54.95	Professional	26	$24.20	$31.02	$54.95
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $59.68 / $76.05 / $110.58	Professional	TC	$59.68	$76.05	$110.58