Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.13 / $13.75 / $16.17	Facility	26	$12.13	$13.75	$16.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $42.48 / $78.05	Professional		$35.67	$42.48	$78.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $11.77 / $26.04	Professional	26	$10.60	$11.77	$26.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.05 / $30.71 / $59.46	Professional	TC	$25.05	$30.71	$59.46
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.75 / $46.26 / $63.59	Professional		$38.75	$46.26	$63.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $13.83 / $17.59	Professional	26	$13.75	$13.83	$17.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.97 / $32.46 / $47.41	Professional	TC	$24.97	$32.46	$47.41
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.92 / $45.45 / $68.12	Professional		$13.92	$45.45	$68.12
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $15.26 / $15.98 / $16.38	Professional	26	$15.26	$15.98	$16.38
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $46.13 / $49.41 / $51.74	Professional	TC	$46.13	$49.41	$51.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.81 / $56.52 / $65.94	Professional		$51.81	$56.52	$65.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.38 / $16.77	Professional	26	$13.18	$14.38	$16.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.63 / $42.14 / $44.60	Professional	TC	$38.63	$42.14	$44.60
United Facility/Professional Professional Modifier Low / Median / High Price $23.17 / $63.59 / $71.28	Professional		$23.17	$63.59	$71.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.16 / $96.66	Professional	26	$12.88	$20.16	$96.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.84 / $36.50 / $51.12	Professional	TC	$15.84	$36.50	$51.12
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $42.52 / $70.05 / $97.66	Professional		$42.52	$70.05	$97.66
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $11.95 / $17.86 / $30.73	Professional	26	$11.95	$17.86	$30.73
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $50.90 / $66.93	Professional	TC	$30.58	$50.90	$66.93