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 $41.30 / $57.11 / $227.10	Professional		$41.30	$57.11	$227.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.03 / $9.73 / $31.82	Professional	26	$9.03	$9.73	$31.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.15 / $77.39 / $96.77	Professional	TC	$35.15	$77.39	$96.77
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 Professional Modifier Low / Median / High Price $48.78 / $82.98 / $112.18	Professional		$48.78	$82.98	$112.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $11.82 / $13.88	Professional	26	$10.61	$11.82	$13.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.02 / $73.58 / $100.94	Professional	TC	$36.02	$73.58	$100.94
HMSA Facility/Professional Professional Modifier Low / Median / High Price $17.30 / $176.26 / $225.30	Professional		$17.30	$176.26	$225.30
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $19.85 / $20.35	Professional	26	$18.96	$19.85	$20.35
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $157.30 / $164.71 / $164.83	Professional	TC	$157.30	$164.71	$164.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $51.01 / $59.51	Professional		$46.76	$51.01	$59.51
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 $36.59 / $39.90 / $42.24	Professional	TC	$36.59	$39.90	$42.24
United Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $57.39 / $66.70	Professional		$21.56	$57.39	$66.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $12.49 / $15.57	Professional	26	$5.72	$12.49	$15.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $45.38 / $51.14	Professional	TC	$15.84	$45.38	$51.14
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $51.96 / $69.84 / $170.06	Professional		$51.96	$69.84	$170.06
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $14.55 / $24.68	Professional	26	$10.85	$14.55	$24.68
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $40.19 / $57.59 / $152.16	Professional	TC	$40.19	$57.59	$152.16