Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.38 / $9.50 / $11.18	Facility	26	$8.38	$9.50	$11.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $35.77 / $170.00	Professional		$29.89	$35.77	$170.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $8.55 / $12.84	Professional	26	$7.33	$8.55	$12.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $27.65 / $55.04	Professional	TC	$22.57	$27.65	$55.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $9.30	Facility	26	$9.30	$9.30	$9.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $36.90 / $55.08	Professional		$30.25	$36.90	$55.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.50 / $9.80 / $12.17	Professional	26	$9.50	$9.80	$12.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $27.31 / $43.90	Professional	TC	$20.59	$27.31	$43.90
HMSA Facility/Professional Professional Modifier Low / Median / High Price $9.81 / $39.46 / $62.48	Professional		$9.81	$39.46	$62.48
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $10.75 / $11.26 / $11.54	Professional	26	$10.75	$11.26	$11.54
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $42.75 / $48.65 / $50.94	Professional	TC	$42.75	$48.65	$50.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $48.96 / $57.12	Professional		$44.88	$48.96	$57.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.11 / $9.94 / $11.59	Professional	26	$9.11	$9.94	$11.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.77 / $39.02 / $41.30	Professional	TC	$35.77	$39.02	$41.30
United Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $55.08 / $61.36	Professional		$19.79	$55.08	$61.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.09 / $11.18 / $13.94	Professional	26	$5.09	$11.18	$13.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.70 / $34.40 / $47.42	Professional	TC	$14.70	$34.40	$47.42
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $35.88 / $57.90 / $85.33	Professional		$35.88	$57.90	$85.33
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $12.45 / $21.23	Professional	26	$8.27	$12.45	$21.23
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $27.61 / $42.96 / $64.08	Professional	TC	$27.61	$42.96	$64.08