Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $15.14 / $18.20	Facility	26	$13.49	$15.14	$18.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $41.69 / $46.77	Facility	TC	$35.48	$41.69	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $95.50	Professional		$34.67	$46.77	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $85.11	Professional	26	$10.96	$15.14	$85.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $31.62 / $60.26	Professional	TC	$20.89	$31.62	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $95.50	Professional		$40.74	$57.54	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.50 / $37.15	Professional	26	$13.49	$19.50	$37.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $58.88	Professional	TC	$26.92	$38.02	$58.88
HMSA Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $66.07 / $70.79	Professional		$40.74	$66.07	$70.79
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.88 / $22.91	Professional	26	$21.38	$21.88	$22.91
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $47.86	Professional	TC	$45.71	$45.71	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $57.54 / $67.61	Professional		$52.48	$57.54	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $16.22 / $18.62	Professional	26	$14.79	$16.22	$18.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $41.69 / $48.98	Professional	TC	$38.02	$41.69	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $89.13	Professional		$52.48	$64.57	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.38 / $27.54	Professional	26	$15.49	$21.38	$27.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $43.65 / $60.26	Professional	TC	$36.31	$43.65	$60.26
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $75.86 / $109.65	Professional		$57.54	$75.86	$109.65
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $20.89 / $37.15	Professional	26	$16.60	$20.89	$37.15
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $74.13	Professional	TC	$38.90	$52.48	$74.13