Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.14 / $16.03 / $18.86	Facility	26	$14.14	$16.03	$18.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.24 / $61.59 / $96.43	Professional		$51.24	$61.59	$96.43
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $15.08 / $21.64	Professional	26	$13.50	$15.08	$21.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $37.71 / $44.55 / $74.80	Professional	TC	$37.71	$44.55	$74.80
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.63 / $66.77 / $83.49	Professional		$61.63	$66.77	$83.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.03 / $17.39 / $20.96	Professional	26	$16.03	$17.39	$20.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.23 / $50.74 / $62.46	Professional	TC	$44.23	$50.74	$62.46
HMSA Facility/Professional Professional Modifier Low / Median / High Price $18.17 / $23.53 / $79.41	Professional		$18.17	$23.53	$79.41
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $18.72 / $19.94 / $20.88	Professional	26	$18.72	$19.94	$20.88
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $55.82 / $59.47 / $62.27	Professional	TC	$55.82	$59.47	$62.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.01 / $69.83 / $81.47	Professional		$64.01	$69.83	$81.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $16.76 / $19.55	Professional	26	$15.37	$16.76	$19.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.64 / $53.06 / $56.16	Professional	TC	$48.64	$53.06	$56.16
United Facility/Professional Professional Modifier Low / Median / High Price $29.17 / $78.56 / $90.11	Professional		$29.17	$78.56	$90.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.57 / $18.86 / $23.51	Professional	26	$8.57	$18.86	$23.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.60 / $59.70 / $66.59	Professional	TC	$20.60	$59.70	$66.59
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $70.63 / $85.29 / $153.79	Professional		$70.63	$85.29	$153.79
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $17.27 / $21.61 / $39.69	Professional	26	$17.27	$21.61	$39.69
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $52.40 / $62.56 / $114.10	Professional	TC	$52.40	$62.56	$114.10