Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.43 / $12.96 / $15.24	Facility	26	$11.43	$12.96	$15.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.78 / $52.49 / $95.85	Professional		$43.78	$52.49	$95.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.61 / $11.85 / $17.48	Professional	26	$10.61	$11.85	$17.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.15 / $40.64 / $78.37	Professional	TC	$33.15	$40.64	$78.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.10 / $13.10 / $13.10	Facility	26	$13.10	$13.10	$13.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.08 / $56.79 / $77.94	Professional		$47.08	$56.79	$77.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $14.20 / $16.94	Professional	26	$12.96	$14.20	$16.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.72 / $42.40 / $62.46	Professional	TC	$33.72	$42.40	$62.46
HMSA Facility/Professional Professional Modifier Low / Median / High Price $13.53 / $61.54 / $82.95	Professional		$13.53	$61.54	$82.95
HMSA Facility/Professional Professional Modifier 26 Low / Median / High Price $14.83 / $15.53 / $15.92	Professional	26	$14.83	$15.53	$15.92
HMSA Facility/Professional Professional Modifier TC Low / Median / High Price $60.61 / $64.01 / $67.03	Professional	TC	$60.61	$64.01	$67.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.32 / $69.06 / $80.58	Professional		$63.32	$69.06	$80.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $13.55 / $15.81	Professional	26	$12.42	$13.55	$15.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.90 / $55.52 / $58.76	Professional	TC	$50.90	$55.52	$58.76
United Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $77.70 / $87.47	Professional		$28.11	$77.70	$87.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.12 / $15.24 / $19.61	Professional	26	$7.12	$15.24	$19.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.99 / $49.93 / $67.86	Professional	TC	$20.99	$49.93	$67.86
University Health Alliance Facility/Professional Professional Modifier Low / Median / High Price $52.58 / $84.57 / $122.43	Professional		$52.58	$84.57	$122.43
University Health Alliance Facility/Professional Professional Modifier 26 Low / Median / High Price $12.00 / $17.01 / $29.90	Professional	26	$12.00	$17.01	$29.90
University Health Alliance Facility/Professional Professional Modifier TC Low / Median / High Price $42.23 / $66.73 / $92.55	Professional	TC	$42.23	$66.73	$92.55